Psychosurgery for self-injurious behavior in Tourette's disorder

J Child Adolesc Psychopharmacol. Winter 2004;14(4):531-8. doi: 10.1089/cap.2004.14.531.

Abstract

One of the most serious and difficult-to-treat conditions in child and adolescent psychiatry is self-injurious behavior (SIB). SIB can be associated with a number of psychiatric disorders, including mental retardation, schizophrenia, borderline personality disorder, pervasive developmental disorders, stereotypic movement disorder, and Tourette's Disorder. A variety of neurosurgical procedures have been used to treat both intractable SIB and severe Tourette's Disorder. Understandably, there are few reports concerning psychosurgery in children and adolescents for any condition or disorder. This report describes the use of cingulotomy and subsequent limbic leucotomy in an adolescent boy with Tourette's Disorder for SIB. His repetitive and medically serious SIB and failure of all other treatments prompted this intervention after careful, comprehensive review and discussion. Following the second surgery, the severity and frequency of his SIB were reduced.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Antipsychotic Agents / therapeutic use
  • Frontal Lobe / surgery
  • Gyrus Cinguli / surgery
  • Humans
  • Male
  • Psychosurgery*
  • Self-Injurious Behavior / drug therapy
  • Self-Injurious Behavior / etiology*
  • Self-Injurious Behavior / surgery*
  • Thalamus / surgery
  • Tourette Syndrome / complications*

Substances

  • Antipsychotic Agents