Surgical Treatment of Tourette Syndrome

Abstract

AbstractThis chapter presents an overview of the existing literature on the functional surgery therapeutic approach in Tourette syndrome (TS) and summarizes the current recommendations for the application of this type of treatment. A special focus is provided with respect to the pending issues concerning this invasive treatment that will need to be addressed in future research. Some technical notes are also given. Deep brain stimulation (DBS) for TS is not curative, and in some cases it does not improve tics. Drugs for TS are prescribed according to the different symptomatology exhibited by the individual patient: Although the same tailored approach is conceivable in choosing the best target for DBS, evidence is still insufficient to provide a sound clinical guidance to target selection. Ongoing technological advances in the surgical procedure (e.g., the introduction of the O-arm and other imaging modalities) have the potential to improve its safety and applicability in routine clinical practice. A patient selection and target selection algorithm, based on evidence from randomized controlled trials and multidisciplinary experiences from tertiary referral centers, is currently under development.