How is tic-tac-toe syndrome treated surgically?

  Tourette’s syndrome, also known as Tourette’s syndrome, the exact cause of its onset is not known and is not generally inherited. The disease is characterized by involuntary facial, neck, limb, and trunk twitching, some accompanied by involuntary vocalizations, and in severe cases, obscenities. The disease usually starts at the age of 4-8 years, with blinking and throat clearing as the first symptoms more often. Generally speaking, tics are a benign, self-limiting disorder that develops at an early age and gradually decreases with maturation. Thiopride and haloperidol tablets are the drugs of choice for treatment.  Less than 20% of patients with Tourette’s syndrome develop a severe form of the disease that is difficult to control with medication, manifesting as frequent vocalizations, obscenities, and frequent twitching of the limbs or trunk. There are even severe self-injurious behaviors such as poking eyes, pulling teeth, poking nose, and hitting their own head and face. There are some patients who do not have self-injurious behaviors but develop severe obsessive-compulsive disorder. If any of these conditions occur, it is possible to control the twitching or compulsive symptoms through surgery. However, because the pathogenesis of the disease is not clear at present, surgery can only be performed to control tic symptoms and relieve obsessive-compulsive behavior by cutting the conduction bundles and nuclei associated with motor coordination in the cerebral thalamus and basal ganglia regions or by implanting stimulators.  Surgery uses stereotactic techniques, which are less invasive and generally do not affect intelligence and other normal functions. The efficiency of surgery for tic control is generally around 70%, and according to our follow-up results, it can reduce tics by 50-90%.