The Obsessive-Compulsive Disorder (OCD) is a psychiatric disease that is marked by anxiety provoking thoughts (obsessions) and accompanied by repetitive and time-consuming behaviors (compulsions) that persist despite patient desire. Tourette's Syndrome is a developmental and neurological disorder that is marked by tics and associated behavioral symptoms, characterized these tics by motor and vocal persistent components. There are a refractory group of patients despite best medical psychiatric and pharmacological treatment, with dramatic evolution in time, with huge personal, familiar and social impact. For this group of patients functional neurosurgery has developed new surgical techniques, these techniques have achieved to change the natural history of disease, with symptoms reduction and quality of life improvement, breaking with this way the old treatment frontiers of these disorders. For these both specific entities limbic basal ganglia loop and accumbens nucleus convert in ideal surgical targets for modulating limbic circuits through a new surgical technique called deep brain stimulation. We describe a case patient report with both disorders coexistence and high complexity and severity symptoms, who was treated with nucleus accumbens deep brain stimulation, the one year outcome after surgery, and also present a literature review of surgical focus of these both entities. [ABSTRACT FROM AUTHOR]