Stereotaxic Amygdalotomy in Behavior Disorders

Balasubramaniam, V.; Ramamurthi, B

doi:10.1159/000103439

Cited by 31 publications

(29 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another 36% of the patients experienced some improvement in their symptoms. 4 Unfortunately, there was no report on the duration of the follow-up period in their study. The authors did find that patients with behavioral disorders associated with epilepsy had better outcomes than those with disorders linked to encephalitis.…”

Section: Resultsmentioning

confidence: 93%

“…39 Heimburger and colleagues 13 reported that 35% of their patients became free of any behavioral abnormalities and that 45% of them had significant improvement. Similarly, Balasubramaniam and Ramamurthi 4 reported on a large clinical series of 100 patients who had undergone bilateral stereotactic amygdalotomy for assaultive, hyperkinetic, destructive, self-destructive, or pyromaniac behavior. The surgical procedure was routinely performed after inducing a state of general endotracheal anesthesia.…”

Section: Resultsmentioning

confidence: 96%

“…The surgical procedure was routinely performed after inducing a state of general endotracheal anesthesia. 3,5 The researchers used PEG or contrast ventriculography to preoperatively define the anatomical target, whereas intraoperative EEG with or without olfactory stimulation was performed in the majority of cases. They used the Leksell stereotactic system with a slight modification consisting of a central hole in the original carrier to facilitate the entrance of the lesioning device.…”

Section: Resultsmentioning

confidence: 99%

“…[1][2][3][4][5]7,[12][13][14][15]24,26,[32][33][34]39,40,45,46 It must be emphasized that a comparison of the results of these series is meaningless given the nonhomogenous populations studied, the differences in the surgical technique applied, and the significantly varying outcome criteria. It has been demonstrated that the amygdala in humans consists of 23 distinct subnuclei, which have been identified.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5]7,[12][13][14][15]24,27,[32][33][34]39,40,[44][45][46] Hitchcock and Cairns 14 reported no procedure-related complications and no postoperative impairment in the intellectual functioning of their patients. Similarly, Balasubramaniam and Ramamurthi 4 reported no postoperative cases of Klüver-Bucy syndrome, memory deficits, or hypersexuality. In another clinical series of 50 patients, Balasubramaniam et al 5 reported 1 case of transient ptosis, 10 cases of transient hemiplegia (which was attributed to the proximity of the crus to the created lesion), and 1 case of prolonged postoperative unconsciousness, irregular temperature, and convulsions in a patient with postencephalitic aggressive behavioral disturbance.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Stereotactic amygdalotomy in the management of severe aggressive behavioral disorders

Mpakopoulou¹,

Gatos²,

Brotis³

et al. 2008

FOC

View full text Add to dashboard Cite

Object Stereotactic amygdalotomy has been utilized as a surgical treatment for severe aggressive behavioral disorders. Several clinical studies have been reported since the first description of the procedure. In the current study, the authors reviewed the literature and evaluated the surgical results, neuropsychological outcome, and complication rate in patients who had undergone stereotactic amygdalotomy for severe aggressive behavioral disorders. Methods The PubMed database was searched using the following terms: “amygdalotomy,” “amygdalectomy,” “amygdaloidectomy,” “psychosurgery,” “aggressive disorder,” and “behavioral disorder.” Clinical series with more than 5 patients undergoing stereotactic amygdalotomy for aggressive or other behavioral disorders were included in this review. The surgical technique, anatomical target, improvement in psychiatric symptomatology, postoperative employment and social rehabilitation, postoperative neurocognitive function, procedure-related complications, and long-term follow-up were evaluated. Results Thirteen clinical studies met our inclusion criteria. Reported postoperative improvement in aggressive behavior varied between 33 and 100%. Procedure-related complication rates ranged from 0 to 42%, whereas the mortality rate was as high as 3.8%. In the majority of the reviewed clinical series, the performance of stereotactic amygdalotomy did not compromise a patient’s learning, language, and intellectual capabilities. The long-term follow-up, although very limited, revealed that initially observed improvement was maintained in most cases. Conclusions Stereotactic amygdalotomy can be considered a valid surgical treatment option for carefully selected patients with medically refractory aggressive behavioral disorders. Recent advances in imaging and stereotactic navigation can further improve outcome and minimize the complication rate associated with this psychosurgical procedure.