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Les maladies concernées, aujourd’hui, par la psychochirurgie

  • Marc Lévêque

En résumé

Les troubles obsessionnels compulsifs,avec par exemple leurs rituels de vérification ou de lavage, peuvent devenir extrêmement invalidants, et dans 10 % des cas ne répondre à aucune psychothérapie ni traitement médicamenteux. Des gestes chirurgicaux très focalisés ont été proposés consistant notamment en des lésions au niveau de la capsule interne ou du cingulum, afin d’interrompre les boucles à l’origine de ces troubles. Ces interventions, de capsulotomie ou de cingulotomie, relativement efficaces, présentent néanmoins l’inconvénient d’être irréversibles, et peuvent rendre certaines complications définitives. Avec l’avènement de la stimulation cérébrale profonde, des cibles comme la capsule interne ont été reprises et d’autres, telles que les noyaux sous-thalamique ou accumbens, sont venues s’y ajouter. Cette stimulation, par des électrodes implantées dans le cerveau, possède l’avantage d’être réversible et adaptable.

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Copyright information

© Springer-Verlag Paris 2013

Authors and Affiliations

  • Marc Lévêque
    • 1
  1. 1.Service de neurochirurgie Hôpital universitaire de la Pitié-Salpêtrière Assistance publiqueHôpitaux de ParisParisFrance

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