Stereotactic surgery on a female patient with severe chronic anorexia nervosa: 10-year follow-up.

Abstract

Anorexia nervosa (AN) is a serious disease with a high rate of chronification. In chronic and serious cases, psychotherapeutic and pharmacological treatments are not sufficient to control the disease. We present the case of a female patient with severe chronic restrictive anorexia nervosa resistant to psychomedical treatment. During the 31years the illness evolved, the patient required multiple hospital admissions. With a body mass index (BMI) of 12.8kg/m2 and consequent risk of death, stereotactic cingulotomy was performed comprising bilateral blocking of the anterior cingulate cortex by stereotactic radiofrequency thermocoagulation, confirmed by tractography 5years later. After 10years of follow-up, the patient is clinically stable with an increased BMI and improved neuropsychological indicators. Stereotactic surgery may be an option for patients with chronic anorexia nervosa where conventional treatments have proved insufficient.