A 29-year-old, right-handed, otherwise healthy man developed severe lifelong Tourette syndrome (TS) beginning at the age of 6 years. Due to its refractory pattern, he underwent deep brain stimulation (DBS) implantation at the centromedian-parafascicular complex thalamic (Figure) when he was 23 years old. His symptoms significantly improved with a Yale Global Tic Severity Scale score reduction from 95 to 281 (Video 1). Improvement was clinically sustained over time using high stimulation parameters (ventral contacts bilaterally with 3 mA, 90 μs, and 160 Hz). However, after a while, he stopped attending proper follow-up appointments until his condition markedly worsened, which led him to return to our hospital.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Jacy Bezerra Parmera, MD, PhD, Movement Disorders Center, Department of Neurology, University of São Paulo School of Medicine, Av. Dr. Enéas de Carvalho Aguiar, 255, 5th Floor, Room 5140, São Paulo 05403000, Brazil (firstname.lastname@example.org).
Published Online: January 3, 2023. doi:10.1001/jamaneurol.2022.4774
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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