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严重的鞭状颈部抽动作为丘脑深部脑刺激的指征:两例报告

Severe Whip-Like Cervical Tics as an Indication For Thalamic Deep Brain Stimulation: Report of Two Cases.

作者信息

Tsuji Masamune, Yamashiro Kei, Morishita Takashi, Hirota Atsushi, Iida Hitoshi, Baba Yasuhiko, Abe Hiroshi

机构信息

Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

出版信息

Tremor Other Hyperkinet Mov (N Y). 2025 May 16;15:24. doi: 10.5334/tohm.1010. eCollection 2025.

DOI:10.5334/tohm.1010
PMID:40385100
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12083071/
Abstract

BACKGROUND

Cervical spinal cord injury caused by cervical tics associated with Tourette syndrome (TS) is a recognized complication; however, the role of deep brain stimulation (DBS) in mitigating the risk of such injuries remains unclear.

CASE REPORT

We report two cases of TS with severe cervical tics, both of which responded favorably to DBS. In one case, DBS prevented the progression of cervical spinal cord injury, whereas in the other case, it prevented its onset.

DISCUSSION

Poor control of severe cervical tics is a significant risk factor for cervical spinal cord injury, and early consideration of DBS is recommended.

HIGHLIGHTS

This case report presents two cases in which deep brain stimulation (DBS) was effective for patients with Tourette syndrome exhibiting severe cervical tics. Through this report, we demonstrate the potential effectiveness of DBS as a treatment to reduce the risk of cervical spinal cord injury caused by severe cervical tics.

摘要

背景

与抽动秽语综合征(TS)相关的颈部抽搐导致的颈髓损伤是一种公认的并发症;然而,深部脑刺激(DBS)在降低此类损伤风险中的作用仍不明确。

病例报告

我们报告了两例伴有严重颈部抽搐的TS病例,两例对DBS均反应良好。一例中,DBS阻止了颈髓损伤的进展,而在另一例中,它预防了颈髓损伤的发生。

讨论

严重颈部抽搐控制不佳是颈髓损伤的一个重要危险因素,建议早期考虑DBS。

要点

本病例报告展示了两例深部脑刺激(DBS)对表现出严重颈部抽搐的抽动秽语综合征患者有效的病例。通过本报告,我们证明了DBS作为一种治疗方法在降低严重颈部抽搐导致颈髓损伤风险方面的潜在有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3dc/12083071/d5c402827049/tohm-15-1-1010-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3dc/12083071/4cd98c6a637f/tohm-15-1-1010-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3dc/12083071/d5c402827049/tohm-15-1-1010-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3dc/12083071/4cd98c6a637f/tohm-15-1-1010-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3dc/12083071/d5c402827049/tohm-15-1-1010-g2.jpg

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本文引用的文献

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Surgical Concepts and Long-term Outcomes of Thalamic Deep Brain Stimulation in Patients with Severe Tourette Syndrome: A Single-center Experience.丘脑深部电刺激治疗重度抽动秽语综合征的手术理念及长期疗效:单中心经验
Neurol Med Chir (Tokyo). 2024 Aug 15;64(8):289-298. doi: 10.2176/jns-nmc.2023-0254. Epub 2024 Jun 19.
2
Microlesion Effect Induced by Electrode Implantation in the Posteroventral Globus Pallidus Interna for Severe Dystonic Tics.电极植入苍白球内侧后腹侧部引起的微损伤效应治疗严重运动性抽动症。
Tremor Other Hyperkinet Mov (N Y). 2024 Jan 18;14:5. doi: 10.5334/tohm.837. eCollection 2024.
3
Precision Mapping of Thalamic Deep Brain Stimulation Lead Positions Associated With the Microlesion Effect in Tourette Syndrome.
丘脑深部脑刺激导联位置与抽动秽语综合征微损伤效应的精确定位。
Neurosurgery. 2023 Oct 1;93(4):875-883. doi: 10.1227/neu.0000000000002484. Epub 2023 Apr 14.
4
European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part IV: deep brain stimulation.欧洲抽动秽语综合征和其他抽动障碍临床指南 2.0 版。第四部分:深部脑刺激。
Eur Child Adolesc Psychiatry. 2022 Mar;31(3):443-461. doi: 10.1007/s00787-021-01881-9. Epub 2021 Oct 4.
5
Association of Tourette Syndrome and Chronic Tic Disorder With Cervical Spine Disorders and Related Neurological Complications.妥瑞氏症候群与慢性抽动障碍与颈椎疾病及相关神经系统并发症之关联性。
JAMA Neurol. 2021 Oct 1;78(10):1205-1211. doi: 10.1001/jamaneurol.2021.2798.
6
Neuroanatomical considerations for optimizing thalamic deep brain stimulation in Tourette syndrome.神经解剖学考虑优化抽动秽语综合征的丘脑深部脑刺激。
J Neurosurg. 2021 Aug 6;136(1):231-241. doi: 10.3171/2021.2.JNS204026. Print 2022 Jan 1.
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Current Management of Tics and Tourette Syndrome: Behavioral, Pharmacologic, and Surgical Treatments.目前的抽动症和妥瑞氏综合征的治疗方法:行为、药物和手术治疗。
Neurotherapeutics. 2020 Oct;17(4):1681-1693. doi: 10.1007/s13311-020-00914-6.
8
Surgical management of adverse events associated with deep brain stimulation: A single-center experience.与脑深部电刺激相关不良事件的外科治疗:单中心经验
SAGE Open Med. 2020 Mar 19;8:2050312120913458. doi: 10.1177/2050312120913458. eCollection 2020.
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Korean J Neurotrauma. 2019 Sep 18;15(2):199-203. doi: 10.13004/kjnt.2019.15.e24. eCollection 2019 Oct.
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Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders.实践指南推荐摘要:抽动障碍患者和慢性抽动障碍的治疗。
Neurology. 2019 May 7;92(19):896-906. doi: 10.1212/WNL.0000000000007466.