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At least 37 records · Page 2Linked to original sources
PubMed1998

Case report of a patient with complex partial frontal lobe seizures as a complication of bifrontal lobotomy.

This case report describes an 85 year-old woman who underwent a bilateral frontal lobotomy for presumed schizophrenia 50 years ago. The patient presented with sudden alterations of consciousness accompanied by motionless staring and speech and movement arrest. After 5 to 10 seconds, contact recovered briskly. As there was electrophysiological evidence for a frontal epileptic focus, these fits were classified as complex partial frontal lobe seizures with impairment of consciousness at onset. An aetiological link with the bifrontal lobotomy is probable. At the occasion of this case report, complications of frontal lobotomy are reviewed.

Aged↗
PubMed1981

alpha 1- and alpha 2-adrenoceptors in rat cerebral cortex: effect of frontal lobotomy.

Surgical noradrenergic denervation of the cortex via frontal lobotomy was used to destroy the noradrenergic nerve endings and thus give some insight into the distribution of alpha-adrenoceptors. Frontal lobotomy caused a reduction in noradrenaline content in rat cerebral cortex (2.1 +/- 0.4 ng/mg protein for lesioned side, 6.0 +/- 0.3 mg/mg protein for non-lesioned side), indicating an effective noradrenergic denervation. The differences in 3H-clonidine and 3H-prazosin binding observed following surgery were a significant decrease in the number of alpha 2-adrenoreceptors (115.0 +/- 4.5 to 91.7 +/- 3.2 fmol/mg protein, n = 7, P less than 0.001) and a smaller but significant increase in the number of alpha 1-adrenoceptors (119.7 +/- 2.5 to 131.6 +/- 5.4 fmol/mg protein, n = 7, P less than 0.05) in the lesioned cortex. Results of this study indicate that alpha 2-adrenoceptors located on presynaptic noradrenergic terminals represent only a small proportion of the total alpha 2-adrenoceptors in rat cerebral cortex.

Animals↗
PubMed2001

An autopsy case of the schizophrenic 32 years after lobotomy.

An autopsy case is reported here of a 69-year-old patient with schizophrenia, who was known retrospectively to have had a prefrontal lobotomy 32 years previously. The patient was diagnosed as schizophrenic at the age of 24 and the lobotomy was undertaken 13 years later. The patient was recently found outside in a dehydrated condition and admitted to a general hospital, where he died of respiratory failure. Bilateral cystic lesions were found in the deep white matter of the frontal lobe. The cyst walls consisted of glial fibrous tissues, and severe demyelination with axonal destruction was diffusely observed in the white matter of the frontal lobe. In the thinner frontal cortex without arcuate fibers (U fibers) close to the cavities, cytoarchitectural abnormalities were observed. In the thalamic nuclei marked retrograde degeneration and astrocytic gliosis were observed. The detailed neuropathological findings of a lobotomized schizophrenic brain are reported here. It is proposed that one should be reminded of a lobotomized brain if bilateral cysts are found.

Aged↗
PubMed1992

Prefrontal lobotomy and hypofrontality in patients with schizophrenia: an integration of the findings.

A case of a schizophrenic patient who suffered a frontal lobotomy is presented as the impetus for a discussion of an alternative neurobiologic model of schizophrenia to integrate the findings of prefrontal lobotomy and "hypofrontality". The proposal that primary temporolimbic pathology may result in secondary hypofunction in the prefrontal lobes is examined in light of current structural neuropathologic evidence. Directions for future research suggested by such a model are explored.

Adult↗
PubMed1993

[Lobotomy at the Gaustad hospital].

The case records of 300 patients who were lobotomized, and 19 patients who had stereotaxic brain surgery during the period 1941-72 at Gaustad Hospital have been studied. The investigation shows that the practice of lobotomy was quite widespread. During the 1950s, lobotomy was carried out on broader indications than normally thought to be the case. Relatives were usually asked for their consent, but the information they received was often questionable. Many of the operations were fatal, particularly in the initial years, and this result can be traced to one specific surgeon.

Adult↗
PubMed1975

Lobotomy in private practice.

In a follow-up of 43 private psychiatric patients referred for open bimedial prefrontal lobotomies between 1948 and 1970, patients were rated by personal interviews and review of medical records for symptom improvement and organic brain syndromes. Initial diagnoses were obsessive-compulsive neurotic (27), hypochondriacal neurotic (five), manic-deprresive (depressed) (one), and schizophrenic (ten). All had been severely impaired by illness intractable to extensive previous treatment. Thirty-five were found to be virtually free of symptoms that prompted operation, six had some improvement, and two were unimproved. Six had moderate to severe organic brain syndromes; three had seizure disorders necessitating treatment; and 17 incurred substantial weight gains. Best results were for hypochondriacal and obsessive-compulsive neurotic patients with phobic symptoms: poorest results were for paranoid schizophrenic subjects. This study was undertaken to provide some increment of data that could aid ongoing efforts to evaluate the consequences of this treatment.

Adult↗
PubMed2000

From Laennec to lobotomy: teaching medical history at academic medical centers.

Although clinicians without a sense of history may not be condemned to repeat the past, the historical record offers many informative lessons. For one thing, history demonstrates the changing nature of scientific knowledge; current understandings of health and disease may prove as ephemeral as earlier discarded theories. In addition, history reminds us that social and cultural factors influence how physicians diagnose and treat various medical conditions. When attempting to teach the history of medicine at academic medical centers, instructors should be innovative as opposed to comprehensive. Students and residents are likely to find recent historical issues to be more relevant, particularly when such material can be integrated into the existing curriculum. Provocative topics include depictions of medicine in old Hollywood films, the contributions made by famous physicians at one's own institution, and historical debates over controversial events, such as the Tuskegee syphilis study and the use of lobotomy in mental institutions in the 1950s.

Academic Medical Centers↗
PubMed2005

Lobotomy in Norwegian psychiatry.

Lobotomy is still a hidden chapter in the history of Norwegian psychiatry. The main reasons, which are discussed here, may have been the role of Ørnulv Ødegård at Gaustad Hospital in Oslo and the links between health authorities and the power élite in Norwegian psychiatry.

History, 20th Century↗
PubMedDate not supplied

[Lobotomy and leucotomy in Brazilian mental hospitals].

Lobotomy and leucotomy were used in Brazilian mental institutions from 1936 to 1956. Also called psycho-surgeries, they were operations that separated the right and left frontal lobes and pre-frontal lobes from the rest of the brains, aiming at modifying behavior or curing mental diseases. The technique, created by the Portuguese neurologist Egas Moniz in 1935 and developed by Walter Freeman from the United States, arrived in Brazil through the hands of Aloysio Mattos Pimenta, neurologist from Hospital PsiquiátricoJuquely in São Paulo. Soon, many doctors followed suit. These procedures were used on more than a thousand in-patients aiming at not only healing results, but also the technical improvement of the surgical technique, since preliminary experiments with animals were quite rare at the time. In Brazil, the technique was used until 1956, when it was considered as going against the 1947 Nuremberg Code, whose objective was to detain and regulate the medical experiments with human beings made during the Second World War.

Brazil↗
PubMedDate not supplied

Low prolactin levels in cerebrospinal fluid: an after effect of lobotomy in chronic schizophrenia.

In order to elucidate the interplay of prolactin and dopamine in schizophrenia, base-line levels of prolactin were assayed in the cerebrospinal fluid (CSF) of chronic schizophrenic patients with or without lobotomy. Cental and cortical atrophy and significantly lowered CSF prolactin levels were found in lobotomized patients in comparison to equally neuroleptic-treated non-lobotomized patients. The mean CSF prolactin level in the female patients was significantly higher than in the male patients. This study did not support the 'dopamine hypothesis' of schizophrenia, since CSF prolactin levels did not correlate with schizophrenic symptoms. The brain atrophy blocked completely the expected elevation of CSF prolactin levels induced by neuroleptics.

Adult↗
PubMed1978

[Studies of the expectancy wave (CNV) in patients with interruption of the thalamo-prefrontal interconnnection pathways caused by psychosurgical prefrontal lobotomy operations].

Frontal and vertex CNVs were studied in 8 selected nonschizophrenic patients subjected to unilateral or bilateral extensive prefrontal lobotomy. The dorsomedial thalamo-frontal pathways had been severed and their regeneration must be considered impossible. Standard CNV task (S1-S2-R) was followed in order to elicit CNVs from the frontal areas anterior to the line of sections and at Cz. In 7 out of 8 patients it was quite easy to evoke CNV with almost normal features and equal latencies in each case from all the cortical areas explored. These results show that CNV formation is not grossly altered in the prefrontal areas which have been irreversibly deprived of normal bi-directional mediothalamic-frontocortical connnections. This suggests that the role of the dorsomedial thalamo-frontal pathways are not essential in the genesis of the frontal CNV in humans. These findings would suggest that the CNV is a diffuse electrical event essentially related to a unitary cerebral process mediated fundamentally by nonspecific ascending meso-diencephalic reticular systems. The differences in morphology and polarity of the CNVs detectable in various brain structures are presumably related to their intrinsic anatomo-functional characteristics and to the method commonly utilized in recording the CNV.

Adult↗
PubMed1993

[What can we learn from the lobotomy period?].

In 1991 the Ministry of Health and Social Affairs appointed a Commission of Inquiry, precipitated by a heated public debate on lobotomy. A group of four psychiatrists studied the case records of 300 patients lobotomized at Gaustad Hospital. The main review by the medical group focused on the high mortality rate during the 1940s. Also, surgery was done on broader indications than officially recommended, and the information given to the next of kin was often questionable. Since the obligation of the psychiatric profession also involves involuntary treatment, particular caution should be exercised in administering new methods. It is important to ensure control and critique by society. Ethical considerations should be integrated into quality control.

History, 20th Century↗