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Case Reports
Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.
- Johan Barbier, Loes Gabriëls, Koen van Laere, and Bart Nuttin.
- Departmentsof Neurosciences and Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium. johanbarbier@hotmail.com
- Neurosurgery. 2011 Sep 1; 69 (3): E745-51; discussion E751.
Background And ImportanceState-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD.Clinical PresentationA 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up.ConclusionThis case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.
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