Improved capsulotomy for refractory Tourette's syndrome.
The effects of bilateral anterior capsulotomy were analyzed in 12 patients with Tourette's syndrome (TS). All of the patients underwent bilateral anterior capsulotomy. In 7 patients, the target was the anterior one third of the anterior limb of the capsula interna, while in 5 patients, the posterior one third of this structure was targeted. Radiofrequency thermolesions were created at 80 degrees C for 60 s. These surgeries resulted in a reduction in TS symptoms (motor and vocal tics and/or obsessive-compulsive behavior) of >50% in all patients, regardless of the target. A comparison of the two lesion sites suggests that patients with lesions of the posterior one third of the anterior limb have a greater reduction in TS symptoms (>80%) than patients receiving lesions of the anterior one third of the anterior limb (>50%). No severe, permanent side effects were observed in any patient.
Department of Neurosurgery, Shanghai Second Medical University Rui Jin Hospital, Shanghai, China. bominsun@sh163a.sta.net.cn
Bomin
B
Sun
Scott E
SE
Krahl
Shikun
S
Zhan
Jiankang
J
Shen
D026881:Acupuncture; D002681:China; D003131:Combined Modality Therapy; D004365:Drugs, Chinese Herbal; D004569:Electroencephalography; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000601:surgery; D011612:Psychosurgery; D012189:Retrospective Studies; D005879:Tourette Syndrome / Q000503:physiopathology / Q000601:surgery*
D004365:Drugs, Chinese Herbal