Thermocoagulation treatment of a patient with obsessive compulsive disorder and substance use disorder: case report

Abstract

ABSTRACT Introduction Substance use disorder (SUD) is a set of physical, psychological, behavioral, and cognitive phenomena related to the use of one or more chemical substances as a priority in a person's life that compromises quality of life. A possible cause associated with SUD is obsessive compulsive disorder (OCD). Since they can share the same neuronal network, this serves as a basis for neurosurgical procedures in cases refractory to conventional therapies. Case Report A 31-year-old male patient, with a history of SUD and OCD refractory to conventional therapies, underwent bilateral ablative stereotactic neurosurgery of the anterior limb of the internal capsule, subgenual cingulate region, nucleus accumbens, and cingulate gyrus. Results Up to 30 months of the procedure, the patient showed an absolute improvement in OCD and SUD and reported lack of withdrawal signs or symptoms and/or need to use drugs. Discussion In recent years, ablative neurosurgery has proven to be an alternative to OCD refractoriness, with long-term benefits. Conclusion In the case analyzed, ablative stereotactic neurosurgery was effective in controlling both the signs and symptoms triggered by OCD, as well as those of anxiety and stress.