سآنجكريت | சாங்க்க்ரிட் | सांकृत.com

Surgery For Pyschiatric Illnesses

October 4th, 2009

Perhaps no other illness produces as much suffering as psychiatric diseases.

Brain is seat of all emotions, positive or negative.

Imagine the state of suffering if it were to generate severe intense negative emotions.

Interestingly surgery for psychiatric diseases were the among the first neurosurgical procedures to be ever developed.

The history of pyschiatric surgeries dates back to an Italian neurologist, physiologist, politician and a surgeon called Egas Moniz (1874-1955). He made 2 remarkable discoveries: Cerebral angiography which allows one to visualize the brain vasculature and pre-frontal leucotomy.

For the latter he received a Nobel prize, the only neurosurgeon to get one ever so.

For his study in monkeys, he found that when absolute alcohol was injected into the frontal lobes, it made them extremely docile and passive.

He extrapolated the same logic and used this technique in highly aggressive institutionalized pyschiatric patients who at time had no other option of any drug therapy.

Remarkably, these patients became docile, calm and manageable though were converted into ’social zombies’

This lead to a mass utilization of this procedure, inappropriately at many times which subsequently lead to the down fall of these surgical techniques. Emergence of excellent drugs was another main reason why most of the surgical techniques were abandoned.

However, sadly before this Lobotomies, in which people had their pre-frontal lobes physically “scrambled”,  turned thousands in veritable zombies. It was considered a miracle cure, the quick fix for all serious mental maladies. The infamous Dr. Walter Freeman, with his icepick lobotomy roadshow , would today not seem out of place in a particularly gory Stephen King novel (see figure).

—————————————————————————————————————————

Figure Legend: The above photograph shows the infamous Dr Freeman who would use an ice pick to pierce it into the skull from just below the eyebrow and rotate it inside so as to disconnect the frontal lobes completely from the rest of the brain. He would perform 20-30 of these procedures in full view of many spectators without the use of any aseptic measures like gloves, masks etc. It was not surprising that many of these procedures resulted in severe complications and made ‘pyscho surgery’ totally unpopular.

—————————————————————————————————————————

He would perform 20-30 of these procedures in a day with many of them developing serious complications and this part of history looking back remains a serious blotch which further impended the development of surgery for psychiatric illnesses.

However later on more mature surgeons like Ballantine in the middle of the 20th century did a more systematic approach and developed psycho surgery which had minimal complications.

As of today, with the development of micro chip, IT and computer technology, pyscho surgery is coming back in a big way.

However it is only used for serious psychiatric conditions totally refractory to medical treatment e.g severe depression with sucidal tendencies, severe obsessive compulsive disorders (where a person develops tendencies to repeat an act e.g washing hands over and over again sometimes thousands of times a day.

Given below are the few of the procedures which are gaining popularity:

Cingulotomy: Cingulate gyrus is part of the frontal lobes involved in thinking, analysis and judgement. However in many psychiatric illnesses, they become over active leading to severe mal adjustment in the society. Small lesions produced here using a thermal RF lesion maker produces significant relief in these patients [sometimes upto 70-80%].

Deep brain stimulation: Placement of electronic leads connected to a micro chip based programmer produces continuous electrical stimulation leading to significant improvement.

Vagal nerve stimulation: Here a small generator is placed in the chest which connect by a wire to stimulate the vagal nerve, a nerve in the neck to treat severe depression.

Micro electrode recordings and functional MRI’s: Newer techniques like mentioned here can actually actually localize areas in brain which produce impulses leading to ‘thoughts’ generating to socially inappropriate behavior.

The other procedures include subcaudate tractomy, limbic leucotomy and anterior capsulotomy which involve producing small lesions in the deeper specific areas of brain which produces significant improvement.

It is likely that over the coming years, with the development of neuro-technology, more and more refined techniques will be developed which will involve fusion of cyber and neuro sciences which will help to treat not only psychiatric illnesses but also improve normal physiological functions like thinking, intelligence and memory.

No related posts.

Filed under: लोकसंवाद