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Vol. 86, No. 2, 2008
Issue release date: March 2008
Section title: Case Report
Stereotact Funct Neurosurg 2008;86:87–91
(DOI:10.1159/000112429)

Microelectrode-Guided Deep Brain Stimulation for Tourette Syndrome: Within-Subject Comparison of Different Stimulation Sites

Shields D.C. · Cheng M.L. · Flaherty A.W. · Gale J.T. · Eskandar E.N.
Departments of aNeurosurgery and bNeurology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass., USA

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Article / Publication Details

First-Page Preview
Abstract of Case Report

Published online: 12/12/2007

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 1

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN

Abstract

Background: As medical therapy for Tourette syndrome (TS) is ineffective in a small subset of patients, surgical interventions, including deep brain stimulation at various sites, have been developed in recent years. Case Description: We present the case of a 40-year-old woman with TS whose severe tics had caused unilateral blindness. Despite trials of more than 40 medications, her symptoms improved significantly only after placement of bilateral deep brain stimulators in the anterior inferior internal capsule. However, symptomatic improvement was not complete, and her electrode connections eventually became permanently damaged by the remaining retrocollic jerks. She underwent removal of the internal capsule electrodes and placement of centromedian nucleus thalamic stimulators with significantly improved tic control. Conclusion: Whereas the anterior internal capsule site had also produced psychiatric side effects such as altered mood and impulse control, the thalamic site has not done so to date. Thus, distinct surgical targets for TS may be appropriate for patients with specific comorbidities.


Article / Publication Details

First-Page Preview
Abstract of Case Report

Published online: 12/12/2007

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 1

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: http://www.karger.com/SFN


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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