Obsessive-compulsive disorder surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Obsessive-compulsive disorder}} | {{Obsessive-compulsive disorder}} | ||
{{CMG}} | {{CMG}}; {{AE}}{{Priyanka}} {{Sonya}}, {{USAMA}} | ||
==Overview== | ==Overview== | ||
For some patients, neither medication, support groups nor psychological treatments are helpful in alleviating obsessive-compulsive symptoms. These patients may choose to undergo [[psychosurgery]] as a last resort | For some patients with severe OCD, neither medication, support groups nor [[psychological]] treatments are helpful in alleviating obsessive-compulsive symptoms. These patients may choose to undergo [[psychosurgery]] as a last resort. [[Deep-brain stimulation]] and [[vagus nerve stimulation]] are possible surgical options which do not require the destruction of [[brain tissue]], although their efficacy has not been conclusively demonstrated.<ref name="pmid28384832">{{cite journal| author=Hirschtritt ME, Bloch MH, Mathews CA| title=Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. | journal=JAMA | year= 2017 | volume= 317 | issue= 13 | pages= 1358-1367 | pmid=28384832 | doi=10.1001/jama.2017.2200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28384832 }} </ref> | ||
==Surgery== | ==Surgery== | ||
===Psychosurgery=== | ===Psychosurgery=== | ||
For | *For patients whose condition does not improve with other medications and treatments, procedures may be the chosen course of treatment. | ||
*These patients may choose to undergo [[psychosurgery]] as a last resort. In this procedure, a surgical [[lesion]] is made in an area of the [[brain]] (the cingulate bundle). In one study, 30% of participants benefited significantly from this procedure. | |||
*[[Deep-brain stimulation]] and [[vagus nerve stimulation]] are possible surgical options which do not require the destruction of [[brain tissue]], however their efficacy has not been established.<ref name="pmid28384832">{{cite journal| author=Hirschtritt ME, Bloch MH, Mathews CA| title=Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. | journal=JAMA | year= 2017 | volume= 317 | issue= 13 | pages= 1358-1367 | pmid=28384832 | doi=10.1001/jama.2017.2200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28384832 }} </ref> | |||
===Ablative procedures=== | ===Ablative procedures=== | ||
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*Subcaudate tractotomy | *Subcaudate tractotomy | ||
*Limbic leucotomy (combining anterior cingulotomy and capsulotomy) | *Limbic leucotomy (combining anterior cingulotomy and capsulotomy) | ||
==Overview== | |||
Surgical intervention is not recommended for the management of [disease name]. | |||
OR | |||
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3] | |||
OR | |||
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3]. | |||
OR | |||
The feasibility of surgery depends on the stage of [malignancy] at diagnosis. | |||
OR | |||
Surgery is the mainstay of treatment for [disease or malignancy]. | |||
==Indications== | |||
*Surgical intervention is not recommended for the management of [disease name]. | |||
OR | |||
*Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either: | |||
**[Indication 1] | |||
**[Indication 2] | |||
**[Indication 3] | |||
*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either: | |||
**[Indication 1] | |||
**[Indication 2] | |||
**[Indication 3] | |||
==Surgery== | |||
*The feasibility of surgery depends on the stage of [malignancy] at diagnosis. | |||
OR | |||
*Surgery is the mainstay of treatment for [disease or malignancy]. | |||
==Contraindications== | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Psychiatry]] | [[Category:Psychiatry]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
Latest revision as of 17:02, 23 April 2021
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Obsessive-compulsive disorder Microchapters |
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Differentiating Obsessive-Compulsive Disorder from other Diseases |
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Obsessive-Compulsive Disorder due to Another Medical Condition |
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Diagnosis |
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Treatment |
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Case Studies |
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Obsessive-compulsive disorder surgery On the Web |
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American Roentgen Ray Society Images of Obsessive-compulsive disorder surgery |
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Directions to Hospitals Treating Obsessive-compulsive disorder |
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Risk calculators and risk factors for Obsessive-compulsive disorder surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyanka Kumari, M.B.B.S[2] Sonya Gelfand, Usama Talib, BSc, MD [3]
Overview
For some patients with severe OCD, neither medication, support groups nor psychological treatments are helpful in alleviating obsessive-compulsive symptoms. These patients may choose to undergo psychosurgery as a last resort. Deep-brain stimulation and vagus nerve stimulation are possible surgical options which do not require the destruction of brain tissue, although their efficacy has not been conclusively demonstrated.[1]
Surgery
Psychosurgery
- For patients whose condition does not improve with other medications and treatments, procedures may be the chosen course of treatment.
- These patients may choose to undergo psychosurgery as a last resort. In this procedure, a surgical lesion is made in an area of the brain (the cingulate bundle). In one study, 30% of participants benefited significantly from this procedure.
- Deep-brain stimulation and vagus nerve stimulation are possible surgical options which do not require the destruction of brain tissue, however their efficacy has not been established.[1]
Ablative procedures
The ablative procedures used for OCD treatment include:[1]
- Anterior cingulotomy
- Capsulotomy
- Subcaudate tractotomy
- Limbic leucotomy (combining anterior cingulotomy and capsulotomy)
Overview
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Indications
- Surgical intervention is not recommended for the management of [disease name].
OR
- Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
- [Indication 1]
- [Indication 2]
- [Indication 3]
- The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
- [Indication 1]
- [Indication 2]
- [Indication 3]
Surgery
- The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
- Surgery is the mainstay of treatment for [disease or malignancy].
Contraindications
References
- ↑ 1.0 1.1 1.2 Hirschtritt ME, Bloch MH, Mathews CA (2017). "Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment". JAMA. 317 (13): 1358–1367. doi:10.1001/jama.2017.2200. PMID 28384832.