Anesthesia considerations in surgical deep brain stimulation for Tourette syndrome management

authors:

avatar shayesteh khorasanizadeh ORCID 1 , * , avatar Nima Saeedi ORCID 2 , avatar Hamed Javadian 3 , avatar Reza Jalil Khoshnood 3 , avatar Alireza Zali 3 , avatar Gholamreza Mohseni ORCID 1 , avatar Davood Ommi 1 , avatar Houman Teymourian ORCID 1

Anesthesiology Research Center, Department of Anesthesiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Anesthesiology Research Center Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neurofunctional Research Center, Shohada-e-Tajrish, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

how to cite: khorasanizadeh S, Saeedi N, Javadian H, Jalil Khoshnood R, Zali A, et al. Anesthesia considerations in surgical deep brain stimulation for Tourette syndrome management. J Cell Mol Anesth. 2020;5(2):e149599. https://doi.org/10.22037/jcma.v5i2.29473.

Abstract

Tourette?s syndrome (TS) is a neuro-behavioral disease associated by phonic and motor tics with a high frequency of psychiatric co-morbidities. For these cases, deep brain stimulation (DBS) is a developing neuro-modulated treatment option since the first report on a successful surgery in 1999. A male thirty-one years old (77 kg, 178 cm) with diagnosis of Gilles De La Tourette syndrome admitted to neurosurgery ward. His medication included Aripiprazole, pimozide, buspirone, clomipramine, citalopram, phenytoin, Desmopressin and Lithium. The patient underwent implanting DBS (Deep Brain Stimulator) surgery and battery implantation in two steps with two weeks interval. General anesthesia with considerations and according to behavior of disease and drug interactions was performed. The cause and symptoms may be due to central dopaminergic hyperactivity or anomalous dopamine neurotransmission and interventions and anesthesia should be done considering these abnormalities.