Deep brain stimulation of anteromedial globus pallidus interna for severe Tourette's syndrome.

Severe Tourette's syndrome that cannot be managed with medication is now being experimentally treated with deep brain stimulation. Ten of 11 patients in a series reported 48% reduction in motor tics and 56% reduction in phonic tics. Effects were sustained for at least 3 months, and only two patients still required pharmacotherapy. One patient discontinued the treatment because of intolerability, two patients had anxiety, and one had an electronic malfunction. The stimulating electrodes were targeted to the anteromedial globus pallidus interna. Tourette's syndrome is thought to result from a defect in the cortical-basal ganglia-thalamic-cortical neuronal circuit. Stimulation in the thalamus, pallidum, ventral caudate, and anterior internal capsule has been investigated by other centers.