Meneses LO, Valencia GFJ, Hernández SM, Soriano PÁM

Language: Spanish
References: 29
Page: 153-164
PDF size: 434.65 Kb.

ABSTRACT

Antecedents. The term of psychosurgery was introduced by Egaz Moniz in 1937 to describe the ablative procedures of the frontal lobe to diminish psychiatric symptoms. Psychosurgery is a treatment to diminish the symptom of refractory aggressiveness.
Objective. Comparison of aggressiveness before and after psychosurgery.
Method. Three patients with schizophrenia and refractory aggressiveness were selected through a multidiciplinary committe. Diagnosis was confirmed as well as the type of ablative surgery to be made. Scales of objective aggressiveness, psychiatric, psychological and neuropsichological evaluation, as well as a pre-and a postoperating follow-up from 6 to 72 months were applied.
Results. The three cases were distributed of the following way: Refractory aggressiveness case 1 (man of 34 years) and two women (of 36 and 37 year) associated to schizophrenia. Bilateral estereotactical termocingulotomy (TEB) with left termoamigdalectomy was used (first case). The scale of preoperating objective aggressiveness in the three cases had a range between 587 and 579 and postoperative range between 285 and 253. In the case number 2 the auditory hallucinations in the patient diminished for which we do not have an explanation nor exist references in literature. These patients still continue with desires to attack but no longer they carry out it like was before his operation.
Conclusion. Both procedures had favorable results to diminish the aggressiveness. During the follow-up of patients they did not require new internations by uncontrol. Therefore, these surgical techniques continue being a valid therapeutic option for the patients who suffer aggressiveness of difficult control resistant to treatment.

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