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一名难治性强迫症患者接受脑深部电刺激术后出现强迫性皮肤搔抓行为：一例报告。

Compulsive skin-picking behavior after deep brain stimulation in a patient with refractory obsessive-compulsive disorder: A case report.

作者信息

Chang Chun-Hung, Chen Shin-Yuan, Tsai Sheng-Tzung, Tsai Hsin-Chi

机构信息

Department of Psychiatry, China Medical University Hospital Institute of Clinical Medicine, China Medical University, Taichung Department of Neurosurgery Department of Psychiatry, Tzu-Chi General Hospital Institute of Medical Sciences, Tzu-Chi University, Hualien City, Hualien, Taiwan, Republic of China.

出版信息

Medicine (Baltimore). 2017 Sep;96(36):e8012. doi: 10.1097/MD.0000000000008012.

DOI:10.1097/MD.0000000000008012
PMID:28885367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6393004/
Abstract

RATIONAL

The therapeutic effect of deep brain stimulation (DBS) for refractory obsessive-compulsive disorder (OCD) has been studied, but complications after this treatment have rarely been noted.

PATIENT CONCERNS

A 28-year-old man with treatment-resistant OCD received bilateral ventral capsule/ventral striatum stimulation for 12 months.

DIAGNOSIS

Compulsive skin-picking behavior and infection were noted following 12-month DBS treatment.

INTERVENTION

We removed the implanted right-side pulse generator.

OUTCOMES

The local inflammation and skin-picking behavior gradually improved. The stimulator device was re-implanted 4 months later.

LESSONS

We suggest that patients with the OC spectrum should be evaluated for skin-picking behaviors during presurgical and postsurgical follow-up to reduce the infection and device removal rates.

摘要

原理

已对深部脑刺激（DBS）治疗难治性强迫症（OCD）的疗效进行了研究，但这种治疗后的并发症鲜有报道。

患者情况

一名28岁难治性强迫症男性接受了双侧腹侧囊/腹侧纹状体刺激治疗12个月。

诊断

在12个月的DBS治疗后出现强迫性皮肤搔抓行为和感染。

干预措施

我们取出了植入的右侧脉冲发生器。

结果

局部炎症和皮肤搔抓行为逐渐改善。4个月后重新植入了刺激器装置。

经验教训

我们建议，对于患有强迫谱系障碍的患者，应在术前和术后随访期间评估其皮肤搔抓行为，以降低感染率和装置取出率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca9/6393004/60b362348246/medi-96-e8012-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca9/6393004/60b362348246/medi-96-e8012-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fca9/6393004/60b362348246/medi-96-e8012-g001.jpg

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本文引用的文献

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The risk of hardware infection in deep brain stimulation surgery is greater at impulse generator replacement than at the primary procedure.在深部脑刺激手术中，更换脉冲发生器时硬件感染的风险比初次手术时更高。
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Skin picking disorder.皮肤搔抓障碍。
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Deep Brain Stimulation device removal after scar picking behaviors in a patient with treatment-resistant obsessive compulsive disorder.
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Tourette syndrome (TS) bears a higher rate of inflammatory complications at the implanted hardware in deep brain stimulation (DBS).妥瑞氏症（TS）在深部脑刺激（DBS）的植入硬件中发生炎症并发症的比率更高。
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Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder.伏隔核深部脑刺激治疗难治性强迫症
Arch Gen Psychiatry. 2010 Oct;67(10):1061-8. doi: 10.1001/archgenpsychiatry.2010.122.
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Deep brain stimulation: from neurology to psychiatry?深部脑刺激：从神经学到精神病学？
Trends Neurosci. 2010 Oct;33(10):474-84. doi: 10.1016/j.tins.2010.07.002. Epub 2010 Sep 9.
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Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease.丘脑底核的深部脑刺激治疗帕金森病。
Lancet Neurol. 2009 Jan;8(1):67-81. doi: 10.1016/S1474-4422(08)70291-6.
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