Deep Brain Stimulation in Pathological Aggression
| Autor: | Julita Birska, Paweł Sokal, Marcin Rudaś, Marek Harat, Piotr Zieliński |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Obsessive-Compulsive Disorder Deep brain stimulation medicine.medical_treatment Deep Brain Stimulation Hypothalamus Poison control Stimulation Nucleus accumbens Tourette syndrome Intellectual Disability medicine Humans Pathological Aggression business.industry medicine.disease Surgery Treatment Outcome nervous system Anesthesia Quality of Life Female Neurology (clinical) medicine.symptom business |
| Zdroj: | Stereotactic and functional neurosurgery. 93(5) |
| ISSN: | 1423-0372 |
| Popis: | Background: We describe a case of deep brain stimulation in a patient with severe aggression refractory to conservative treatment. The targets of the stimulation were set bilaterally in the posteromedial hypothalamus and - in a second procedure due to its ineffectiveness - in the nucleus accumbens (NAcc) bilaterally. Methods: In the first stage, we implanted electrodes into the posteromedial hypothalamus, after obtaining consent of the Bioethics Committee. In the early postoperative period, we observed significant improvement in the range of 50-90% in terms of quantity and quality of the attacks of aggression. After about 3 weeks, attacks of aggression started to return. Despite changes in the stimulation parameters there was no improvement. For this reason, based on the experience of surgery in patients with obsessive-compulsive disorder, Tourette syndrome and with morbid obesity, we decided to implant electrodes into the NAcc. Results: After 15 months of follow-up, the patient has no aggressive behavior, with no side effects. Conclusions: Although the stimulation of the posterior-medial hypothalamus did not bring long-term benefits, its combination with bilateral stimulation of the NAcc practically freed the patient from aggressive disorders. It significantly improved the patient's quality of life. |
| Databáze: | OpenAIRE |
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