Lobotomy is a surgical procedure performed on the brain, targeting the frontal lobe.
Involves making holes in the skull, removing some brain tissue, and severing connections between the frontal lobe and the thalamus.
Pioneered by Portuguese scientist Egas Moniz, who was awarded the Nobel Prize in 1949 for this work.
Purpose of Lobotomy
Intended to provide relief for mental illnesses unresponsive to standard treatments.
Used primarily in the 1940s and 1950s when psychiatric treatment options were limited.
Conditions treated included schizophrenia, affective disturbances, OCD, severe depression, psychosis, and manic depressive psychosis.
Procedure Details
Surgery aimed to sever nerve fibers between frontal lobe and thalamus.
Various methods were used: brain cannulae, leukotomes, chemical injections, electrocoagulation, and ultrasonic waves.
Results showed some success, with 44-46% of patients released from hospitals in studies from the US, Canada, and UK.
Historical Context
Emerged in the 1930s due to overcrowded mental asylums and lack of effective treatments.
Seen as a hopeful solution, allowing some patients to return home.
Dr. Walter Freeman popularized the procedure in the US, developing the transorbital approach via the eye socket.
Controversial due to severe side effects and ethical concerns about altering personality.
Fell out of favor with the advent of psychiatric medications in the 1950s.
Side Effects
Brain operations are risky due to the organ's delicate nature.
Known side effects include bleeding, infection, dementia, intellectual impairment, epilepsy, apathy, incontinence, obesity, and death (2% mortality rate).
Modern Practices
Today's psychiatric surgeries are more precise and less damaging.
Use of advanced imaging techniques like CT, MRI, and EEG to guide procedures.
Stereotactic neurosurgery is used for intractable pain, epilepsy, movement disorders, and resistant mental health disorders.
Procedures like cingulotomy and deep brain stimulation offer more predictable outcomes.
Conclusion
Lobotomy marked a significant, though controversial, chapter in psychiatric treatment history.
Modern techniques have evolved to provide safer and more effective options for treatment-resistant conditions.