• Alice W Flaherty, Ziv M Williams, Ramin Amirnovin, Ekkehard Kasper, Scott L Rauch, G Rees Cosgrove, and Emad N Eskandar.
• Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
• Neurosurgery. 2005 Oct 1; 57 (4 Suppl): E403; discussion E403.

Objective And ImportanceMedical treatment of Tourette syndrome is often ineffective or is accompanied by debilitating side effects, therefore prompting the need to evaluate surgical therapies.Clinical PresentationWe present the case of a 37-year-old woman with severe Tourette syndrome since the age of 10 years. Her symptoms included frequent vocalizations and severe head and arm jerks that resulted in unilateral blindness. Trials of more than 40 medications and other therapies had failed to relieve the tics.InterventionWe implanted bilateral electrodes in the anterior limb of the internal capsule, terminating in the vicinity of the nucleus accumbens. At 18-month follow-up, optimal stimulation continued to lower her tic frequency and severity significantly.ConclusionOur findings suggest that stimulation of the anterior internal capsule may be a safe and effective procedure for the treatment of Tourette syndrome.

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