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DEEP BRAIN STIMULATION OF THE ANTERIOR INTERNAL CAPSULE



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TECHNICAL CASE REPORTS Alice W Flaherty M D Ph D Department of Neurology Massachusetts General Hospital Harvard Medical School Boston Massachusetts Ziv M Williams M D Department of Neurosurgery Massachusetts General Hospital Harvard Medical School Boston Massachusetts Ramin Amirnovin M D Department of Neurosurgery Massachusetts General Hospital Harvard Medical School Boston Massachusetts DEEP BRAIN STIMULATION OF THE ANTERIOR INTERNAL CAPSULE FOR THE TREATMENT OF TOURETTE SYNDROME TECHNICAL CASE REPORT OBJECTIVE AND IMPORTANCE Medical treatment of Tourette syndrome is often ineffective or is accompanied by debilitating side effects therefore prompting the need to evaluate surgical therapies CLINICAL PRESENTATION We present the case of a 37 year old woman with severe Tourette syndrome since the age of 10 years Her symptoms included frequent vocalizations and severe head and arm jerks that resulted in unilateral blindness Trials of more than 40 medications and other therapies had failed to relieve the tics INTERVENTION We implanted bilateral electrodes in the anterior limb of the internal capsule terminating in the vicinity of the nucleus accumbens At 18 month follow up optimal stimulation continued to lower her tic frequency and severity significantly CONCLUSION Our findings suggest that stimulation of the anterior internal capsule may be a safe and effective procedure for the treatment of Tourette syndrome Ekkehard Kasper M D Ph D KEY WORDS Deep brain stimulation Internal capsule Obsessive compulsive disorder Tourette syndrome Ventral striatum Department of Neurosurgery Massachusetts General Hospital Harvard Medical School Boston Massachusetts Neurosurgery 57 ONS Suppl 3 ONS 403 2005 Scott L Rauch M D Department of Psychiatry Massachusetts General Hospital Harvard Medical School Boston Massachusetts G Rees Cosgrove M D Department of Neurosurgery Massachusetts General Hospital Harvard Medical School Boston Massachusetts Emad N Eskandar M D Department of Neurosurgery



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