Surgery for Tourette’s syndrome

At 9:00 a.m. on December 25, 2010, a difficult surgery was underway at the Bayi Brain Hospital of the Beijing Military General Hospital. The patient undergoing surgery is a 30-year-old patient with Tourette’s syndrome. After installing the leksell-G stereotactic head frame, the surgeon immediately used the first 3.0T intraoperative MRI in China for precise localization. The scanned images were input into the computerized stereotactic surgery planning system for target selection and verification, and designed the surgical approach to simulate the surgical procedure and the pre-set simulated target. Intraoperatively, the leadpoint microelectrode recording system is used to continuously record the cellular electrical signals of the implantation pathway to further understand the accuracy of the implantation location. With the technical assurance provided by this series of digital surgical equipment, the bilateral deep brain stimulator (DBS) electrodes were accurately implanted into the predetermined target sites and the surgery was successfully completed. The patient was mobile the day after surgery, and electrode stimulation was started three weeks later. The patient’s symptoms improved significantly after three months. As described by the patient and his family and evaluated by comparison with the preoperative scale, the symptom improvement rate was 80%. The patient was very satisfied with the outcome of the surgery and told the doctor that he was now free from the pain that the disease had caused him and his family for so many years, allowing him to return to work and to plan his life again. Tourette syndrome (TS) is a neuropsychiatric disorder characterized by sudden, involuntary, multiple twitches accompanied by violent vocalizations and obscenities, and partially accompanied by psychological problems such as inattention, learning difficulties, and emotional disturbances. The surgical patient presented with twitching of the limbs and corners of the mouth, accompanied by involuntary shouting and vocalization of the throat since the age of 5. He was diagnosed with Tourette’s syndrome. 2 years ago, he underwent surgery for left pallidum and right amygdala destruction in other hospitals, and the postoperative symptoms improved unsatisfactorily, which seriously affected the patient’s working life and led to more serious mental and emotional disorders. In order to obtain further treatment, the patient came to Bayi Brain Hospital affiliated to Beijing Military General Hospital. After consultation with functional neurosurgery experts, detailed examination, preoperative evaluation and surgical plan development, it was considered that the latest treatment method, bilateral deep brain stimulation treatment, could be implemented by a fully digital system. The treatment of Tourette’s syndrome is still a worldwide problem, and the medical community is constantly exploring effective treatment methods. In recent years, deep brain stimulation has been gradually carried out abroad with exciting results, and in recent years, this treatment has also been tried in China. Due to the technical difficulty of this procedure, which requires a lot of high technology equipment support to carry out, only a few units in China can carry out it at present.