Leukotomy

Leukotomy is an outmoded treatment for a wide range of psychiatric disorders, involving a type of brain surgery.

Also known as lobotomy, or more commonly as pre-frontal lobotomy, leukotomy is an operation that separates the frontal lobes from the rest of the brain. The operating surgeon drills two holes into the skull and uses an instrument known as a leukotome to cut through brain tissue, thereby widely disrupting brain circuits. The procedure was formerly used widely to treat schizophrenia, depression, and obsessive-compulsive disorder.

Portuguese neurologist Egas Moniz (1874–1955) performed the first leukotomy in Lisbon in 1935 and claimed dramatic improvements in his patients. His idea, that obsessive behavior comes from fixed circuits in the brain that need to be shaken up, was not new. For thousands of years, people have drilled holes in the skull, in a process called trepanning, in an attempt to drive evil spirits out of the brain.

Leukotomy was taken up by American neurologist Walter Freeman (1895–1972) and soon was being performed with great enthusiasm around the world, in the belief that it was a miracle cure for mental illness. At the time, there was little else to offer, except incarceration in an asylum, where treatment of patients was often inhumane. In 1949, Moniz won the Nobel Prize in Physiology for his discovery of leukotomy.

KEY TERMS

Obsessive-compulsive disorder—
A psychiatric illness where excessive anxiety leads to repetitive and ritualistic behaviors which take over an individual's life.
Schizophrenia—
A chronic and major psychiatric disorder characterized by hallucinations, delusions, and social withdrawal.

However, in the 1950s, it became apparent that leukotomy was no cure for psychiatric disorders and left patients withdrawn and apathetic in the long term. Moreover, drug treatments for schizophrenia and depression were being developed, and these clearly were more effective. Like insulin coma therapy and electroconvulsive therapy, leukotomy fell out of favor. It is not performed any more, although more sophisticated forms of brain surgery occasionally are offered to patients who have not responded to other treatments.

See also Electroconvulsive therapy (ECT) ; Insulin shock therapy .

Resources

BOOKS

Shorter, Edward. A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons, 1998.

PERIODICALS

Daniel, Nijensohn, and Goodrich Isaac. “Psychosurgery: Past, Present, and Future, including Prefrontal Lobotomy and Connecticut's Connection.” Connecticut Medicine 78, no. 8 (September 2014): 453–63.

WEBSITES

BBC News Magazine. “The Strange and Curious History of Lobotomy.” http://www.bbc.com/news/magazine15629160 (accessed July 15, 2015).