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destruction or chronic excitation of a part of the brain to treat disordered behavior or function.
psychosurgeryA general term for neurosurgery intended to alleviate psychiatric symptoms. The tools used in modern psychosurgery result in selective tract destruction and include radioactive 90Yt implants in the substantia innominata, cryoprobes, coagulation, proton beams and ultrasonic waves. Psychosurgery is not commonly performed, as it must be first established that a patient is unresponsive to all other therapies and that the condition is chronic (i.e., > 3 years duration).
Significant improvement is reported in 60% of carefully selected patients; in 3%, the symptoms worsen after the procedure. The measurable intelligence quotient may actually increase, due to an improved ability to concentrate and memorise, while distractibility is reduced to a minimum.
Psychosurgery was first performed in 1890 by G Burckhardt. Early psychosurgical procedures included topectomy (removal of pieces of cerebral cortex, weighing 20 g for pain to 50 g for fulminant schizophrenia). Other early procedures included lobectomy and leukotomy (popularised by W Freeman, which consisted of thrusting an icepick-like device through the eye socket and manipulating the handle to rupture myelinated tracts). The Freeman procedure’s popularity peaked in the late 1940s, its decline coinciding with the availability of the first effective psychoactive drugs.
Seen in 1 %, complications include infections, haemorrhage, and seizures.
func·tion·al neu·ro·sur·ger·y(fŭngk'shŭn-ăl nūr'ō-sŭr'jĕr-ē)
Destruction or chronic excitation of a part of the brain to treat disordered behavior or function.
The treatment of diseases of the nervous system in which structurally normal-appearing nerves behave abnormally.. Examples of diseases treated with functional neurosurgery include Parkinson disease and other movement disorders, seizure disorders, and some types of chronic nerve pain.
See also: neurosurgery