Preliminary Report on the Amygdaloidectomy on the Psychotic Patients, With Interpretation of Oral-Emotional Manifestation in Schizophrenics

Abstract

Summary of the Observation The symptoms caused by the destruction of amygdaloid complex in man are: intensification of the anger impulse, changefulness and infantization of emotion and behavior, and increase of friendliness in the emotional aspect; polyphrasia, hyperkinesis, acceleration of psychomotor activity, phagomanic and heterophagous tendency, and want for water, and in two cases such abnormal oral behavior as spitting, and the arcentuation of the sexual impulse in behavioral aspect. In three cases erroneous recognition both of persons and objects nas observed. As these symptoms were entirely absent prior to the operation, being evidently independent from and unrelated to the schizophrenic symptoms, it may rightly be interpreted as the symptoms directly caused by the surgical attack on the amygdaloid complex. These symptoms, of course, varied according to the poatoperative course and circumstances, also never uniform in all the five cases. However, we shall outline below the course of the changes in symptoms for convenience's sake Immediately after the operation the patients under dim consciousness would like to try pulling the bandage off or rolling back and forth on the bed throwing up their four limbs so violently that in same cases it was necessary to tie up the patients to their beds. The dimness of consciousness gets reduced rather rapidly. resuming normality within 3 days at the latest. The first symptoms to be noticed after the operation are polyphrasia and hyperkinesis, the patients are extremely hyperactive violently resisting any effort to stop them. They are talkative, their speech suggests mostly a disconnected, illogicol trend of thought pretty characteristic of schizophrenia. Sometimes they complain about their bodily discomfort such as headache. As in Case 4, the patients sometimes present rather manifest schizophrenic taints than prior to the operation. But in this stage food intake is not yet the major subject of talk, the appetite is still weak. It is about this time that the outrageous tendency and emotional and behavioral changeablenesa gets more pronounced, the patients grow extremely susceptive of stimulation. They fall in rage by trifle chances, very often getting nearly delirous. Gradually they resume a more composed state of mind, though still there persist changeableness of mood and tendency to burstout into anger, while speech and behavior of the patients remain childish even then, they act all like spoilt children. In this stage the patients grow more controllable, more capable to be diverted from anger through effort to calm down or fulfillment of desire. From the 3 rd to 4th day asking for refreshments, cigarettes and water becomes marked, they ask for such things untiringly. They never cease asking by every chance to perceive them until they succeed However, what is interesting about it is that they ask nothing but such luxuries as cigarettes and refreshments, the kind that will not likely be able to fill an empty stomach. The amount that they actually “eat” is never large; ...

Über Das Rhinencephalon

“…Die H y p e rsex u alität h a t in den m eisten Fällen einen unreifen, anorm alen C harakter. Sie war schon von Bucy und K lüver als B estandteil des von ihnen beobach teten Syndrom es m itgeteilt worden [15,83], w ährend Sawa [129] u n d Terzian-Ore 11401 sp äter erstm alig dieses S yndrom beim M en schen beschrieben.…”

Psychiatric Surgery — 1935–1973

“…Possibly influenced by Rosvo1d, Mirsky and Pribram (58) who showed in 1954 that male rhesus monkeys subjected to amygdaloid lesions lost their aggressive patterns of social dominance, and reports by Niemeyer (52) in 1958 and Sawa (59) in 1954 of diminished aggressivity in man following amygdaloid lesions, Narabayashi (49) in Tokyo was the first to report systematically on the amygdalotomies in man that he initiated in 1958 and published in 1963. Then he had a series of 60 cases, 39 of whom had been subjected to a unilateral operation and a decrease in emotional excitability, and aggressivity was found in 85 percent of the patients; two-thirds were epileptics and the follow-up varied between 3-48 months.…”

The Hippocampus as a Cognitive Map

“…More pertinent, perhaps, is the fact that no generalized memory defect was apparent when damage was limited to the uncus and amygdala. Sawa et al (1954) and Terzian and Dalle Ore (1955) have also noted that resections limited to the amygdala do not impair general memory function. Thus, it seemed likely, though not proven, that hippocampal damage was crucial for the memory defect.…”