Improved capsulotomy for refractory Tourette's syndrome

Abstract

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.