Anxiety and related disorders: neurosurgery for OCD: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Anxiety and related disorders: neurosurgery for OCD

Sample item

A man with severe, disabling OCD has failed every drug and behavioural treatment over many years. If a neurosurgical lesion procedure is considered, which is classically used?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Anterior capsulotomy or cingulotomy

For intractable OCD, stereotactic lesions of the anterior limb of the internal capsule (capsulotomy) or the anterior cingulate (cingulotomy) interrupt the cortico-striatal loops. It is a last resort after all other options and requires safeguards under the Mental Healthcare Act.

Option by option

  • A. Hemispherectomy

    Hemispherectomy is used for severe unilateral hemispheric epilepsy.

  • B. Bilateral temporal lobectomy

    Temporal lobectomy is used for medically refractory temporal lobe epilepsy.

  • C. Anterior capsulotomy or cingulotomy (correct)

    Correct. Capsulotomy and cingulotomy interrupt the circuit implicated in OCD.

  • D. Corpus callosotomy

    Corpus callosotomy is used for drop attacks in some forms of epilepsy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Anterior capsulotomy or cingulotomy. For intractable OCD, stereotactic lesions of the anterior limb of the internal capsule (capsulotomy) or the anterior cingulate (cingulotomy) interrupt the cortico-striatal loops.

Why is "Hemispherectomy" not the answer?

Hemispherectomy is used for severe unilateral hemispheric epilepsy.

Why is "Bilateral temporal lobectomy" not the answer?

Temporal lobectomy is used for medically refractory temporal lobe epilepsy.

Why is "Corpus callosotomy" not the answer?

Corpus callosotomy is used for drop attacks in some forms of epilepsy.

What concept does this question test?

It tests Anxiety and related disorders: neurosurgery for OCD in Psychiatry. It is a last resort after all other options and requires safeguards under the Mental Healthcare Act.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anxiety and related disorders: neurosurgery for OCD?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.