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病例探讨----强迫症的术后显效时间

(2009-11-08 15:38:41)
标签:

帕金森病

发作性睡病

强迫症

手术

杂谈

分类: 强迫症
Dear Dr. Liu,

Dr. John Adler recently performed the first Cyberknife capsulotomy at Stanford for a patient of mine with OCD. After 3 months, no lesions were visible on MRI. After 4 months, she has had no improvement at all in her OCD.

May I ask about the series of OCD patients you followed up after 3 years? How soon after bilateral gamma knife capsulotomy was improvement seen in those who ultimately improved?

I and Dr. Adler are trying to decide when and if we should offer our patient a second Cyberknife treatment.

Oliver et al (Stereotac Function Neurosurg 2003;81(1-4)90-95 report that OCD improvement was seen 1 month after bilateral anterior capsulotomy and the results did not change after longer follow-up. Baer et al (Arch Gen Psychiatry. 1995;52:384-392) found OCD improvement was present by 6 months, after cingulotomy. Mindus et al (J Neuropsychiatry and Clin Neurosciences 1994;6:467-477) reports that improvement was essentially stable two months after thermocapsulotomy.

Any information you can provide about the timing of OCD improvement and the appearance of lesion on MRI will be quite helpful.

Thank you in advance.

Lorrin M. Koran, M.D.
--
Professor of Psychiatry, Emeritus
Stanford University Medical Center
Department of Psychiatry and Behavioral Sciences
401 Quarry Road, Room 2363
Stanford, CA 94305

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