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Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome: report of three cases

(2003) JOURNAL OF NEUROSURGERY. 99(6). p.1094-1100
Author
Organization
Abstract
Based on the results of thalamotomies described by Hassler in 1970, the authors performed bilateral thalamic high-frequency stimulation (HFS) in three patients with intractable Tourette syndrome (TS). In this report they describe the long-term effects. Three male patients (42, 28, and 45 years of age) had manifested motor and vocal tics since early childhood. The diagnosis of TS was made according to the criteria of the Tourette Syndrome Classification Study Group. Any drug or alternative treatment had been either ineffective or only temporarily effective in all three patients. There was no serious comorbidity. The target for stimulation was chosen at the level of the centromedian nucleus, substantia periventricularis, and nucleus ventrooralis internus. After 2 weeks of test stimulation, the pulse generators were implanted. After a follow-up period of 5 years in the patient in Case 1, 1 year in the patient in Case 2, and 8 months in the patient in Case 3, all major motor and vocal tics had disappeared and no serious complications had occurred. When stimulation was applied at the voltage necessary to achieve an optimal result on the tics, a slight sedative effect was noted in all three patients. In the patients in Cases 1 and 3 there were stimulation-induced changes in sexual behavior. Chronic thalamic HFS may be an effective and safe treatment for medically intractable TS in adult patients. Unwanted stimulation-induced side effects may occur.
Keywords
LIMBIC LEUKOTOMY, BASAL GANGLIA, GILLES, DISEASE, INTRALAMINAR, NEUROANATOMY, DYSFUNCTION, SELECTION, MIDLINE, deep brain stimulation, thalamus, Tourette syndrome, high-frequency stimulation, OBSESSIVE-COMPULSIVE DISORDER

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MLA
Visser-Vandewalle, V et al. “Chronic Bilateral Thalamic Stimulation: a New Therapeutic Approach in Intractable Tourette Syndrome: Report of Three Cases.” JOURNAL OF NEUROSURGERY 99.6 (2003): 1094–1100. Print.
APA
Visser-Vandewalle, V., Temel, Y., Boon, P., Vreeling, F., Colle, H., Hoogland, G., Groenewegen, H., et al. (2003). Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome: report of three cases. JOURNAL OF NEUROSURGERY, 99(6), 1094–1100.
Chicago author-date
Visser-Vandewalle, V, Y Temel, Paul Boon, F Vreeling, H Colle, G Hoogland, HJ Groenewegen, and C Van der Linden. 2003. “Chronic Bilateral Thalamic Stimulation: a New Therapeutic Approach in Intractable Tourette Syndrome: Report of Three Cases.” Journal of Neurosurgery 99 (6): 1094–1100.
Chicago author-date (all authors)
Visser-Vandewalle, V, Y Temel, Paul Boon, F Vreeling, H Colle, G Hoogland, HJ Groenewegen, and C Van der Linden. 2003. “Chronic Bilateral Thalamic Stimulation: a New Therapeutic Approach in Intractable Tourette Syndrome: Report of Three Cases.” Journal of Neurosurgery 99 (6): 1094–1100.
Vancouver
1.
Visser-Vandewalle V, Temel Y, Boon P, Vreeling F, Colle H, Hoogland G, et al. Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome: report of three cases. JOURNAL OF NEUROSURGERY. 2003;99(6):1094–100.
IEEE
[1]
V. Visser-Vandewalle et al., “Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome: report of three cases,” JOURNAL OF NEUROSURGERY, vol. 99, no. 6, pp. 1094–1100, 2003.
@article{668839,
  abstract     = {Based on the results of thalamotomies described by Hassler in 1970, the authors performed bilateral thalamic high-frequency stimulation (HFS) in three patients with intractable Tourette syndrome (TS). In this report they describe the long-term effects. Three male patients (42, 28, and 45 years of age) had manifested motor and vocal tics since early childhood. The diagnosis of TS was made according to the criteria of the Tourette Syndrome Classification Study Group. Any drug or alternative treatment had been either ineffective or only temporarily effective in all three patients. There was no serious comorbidity. The target for stimulation was chosen at the level of the centromedian nucleus, substantia periventricularis, and nucleus ventrooralis internus. After 2 weeks of test stimulation, the pulse generators were implanted. After a follow-up period of 5 years in the patient in Case 1, 1 year in the patient in Case 2, and 8 months in the patient in Case 3, all major motor and vocal tics had disappeared and no serious complications had occurred. When stimulation was applied at the voltage necessary to achieve an optimal result on the tics, a slight sedative effect was noted in all three patients. In the patients in Cases 1 and 3 there were stimulation-induced changes in sexual behavior. Chronic thalamic HFS may be an effective and safe treatment for medically intractable TS in adult patients. Unwanted stimulation-induced side effects may occur.},
  author       = {Visser-Vandewalle, V and Temel, Y and Boon, Paul and Vreeling, F and Colle, H and Hoogland, G and Groenewegen, HJ and Van der Linden, C},
  issn         = {0022-3085},
  journal      = {JOURNAL OF NEUROSURGERY},
  keywords     = {LIMBIC LEUKOTOMY,BASAL GANGLIA,GILLES,DISEASE,INTRALAMINAR,NEUROANATOMY,DYSFUNCTION,SELECTION,MIDLINE,deep brain stimulation,thalamus,Tourette syndrome,high-frequency stimulation,OBSESSIVE-COMPULSIVE DISORDER},
  language     = {eng},
  number       = {6},
  pages        = {1094--1100},
  title        = {Chronic bilateral thalamic stimulation: a new therapeutic approach in intractable Tourette syndrome: report of three cases},
  url          = {http://dx.doi.org/10.3171/jns.2003.99.6.1094},
  volume       = {99},
  year         = {2003},
}

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