Bilateral globus pallidus lesions in a patient with tourette syndrome and related disorders

Background: The neuroanatomic and pathologic basis of Tourette's syndrome o r related disorders such as obsessive-compulsive disorder and attention def icit-hyperactivity disorder remains unknown. Although a substantial body of neuroimaging and other data implicate basal ganglia and some point out spe cifically the globus pallidus in the etiopathogenesis of these three relate d disorders, no clear or pathologically significant isolated lesions restri cted to this region have yet been demonstrated, with the exception of obses sive-compulsive disorder. Methods: A seventeen-year-old male case of Tourette syndrome with comorbid obsessive-compulsive disorder, attention deficit-hyperactivity disorder, st uttering and gait disturbance, who had negative family history is presented . Results: The patient has failed to respond to drug treatment and his MRI sc an revealed bilateral and symmetrical globus pallidus lesions with specific "tiger's eye" appearance of unknown etiology. Conclusions: Well-localized lesions in the globus pallidus support growing data suggesting the involvement of this brain region in Tourette syndrome a nd related disorders. (C) 1999 Society of Biological Psychiatry.