立体定向脑内核团毁损治疗抽动-秽语综合征

The Clinical Analysis of Intractable Tourette′s Syndrome with Stereotactic Techniques

目的:探讨立体定向技术和脑内核团毁损对抽动-秽语综合征的治疗意义。方法:18例抽动-秽语综合征术前经过系统的精神药物及心理行为治疗,仍不能控制症状的内科治疗困难的患者。应用MRI在立体定向的基础上,选择性射频热凝苍白球、杏仁核、扣带回、内囊前肢靶点。并在术前、术后应用耶鲁综合抽动严重程度量表(YGTSS)、韦氏成人智力量表(WAIS)进行评分。结果:手术后YGTSS的运动抽动评分、发声抽动评分较术前明显减少(P<0·01);手术前后WAIS智力量表评分无明显变化。无严重并发症和后遗症。结论:立体定向核团射频热凝治疗内科治疗困难的抽动-秽语综合征是安全有效的方法之一。

Aim： To study the significance of intractable Tourette＇s syndrome by using nucleus lesion and stereotactic technique.Methods： 18 patients, with Tourette＇ s syndrome, who were previously failed with psychophannacological and behavioural therapy.All patients selectively lesioned nucleus （pallidum, amygdalae, cingnlate gyrus, capsula intema crus anterius） by stereotactic technique connected with MRI.And the therapeutic effects were estimated with Yale Global Tic Severity Scale （YGTSS） and Wechsler Adult Intellingence Scale （WAIS）. Results： The reduced proportion of vocal tic scale was less than motor tic scale. There was no intelligence harm. Complication and sequela did not occurred. Conclusion：The stereotactic technique with nucleus lesion is an effective method to treat intractable Tourette＇s syndrome.