And not forgetting the others….

In the early 1970s a group of Scottish doctors experimented with brain operations, amygdalotomies, for the treatment of aggression. Their patients included two children aged under 10 and a further 5 young people aged under 20. Thirteen of their seventeen patients had epileptic seizures, but the operations were carried out in an attempt to control aggression, not seizures: “A strong history of aggression was obtained in all cases. Many of those patients in whom the prime reason for referral was that of aggression, had associated personality disorders.” The doctors describe the operations:

“Wherever possible, procedures were performed without premedication under local anaesthesia. Nine patients were operated on under local anaesthesia and one was anaesthetized for the preliminary stereotactic procedure and when the probe was inserted the patient was allowed to waken up. The remaining eight patients had bilateral amygdalotomy performed under general anaesthesia because of their aggressive behaviour, and were considered too disturbed to undergo the procedure under local anaesthesia. Even those who were considered suitable for local anaesthesia often behaved violently during stimulation of the temporal lobe structures, disturbing the sterile enviroment and trying to tear the stereotactic instrument from their heads. Five of the 17 patients showed extreme restlessness and disturbed behaviour during the procedures.”

From E R Hitchcock, G W Ashcroft, V M Cairns & L G Murray, Observations on the development of an assessment scheme for amydgalotomy, in L V Laitinen and K E Livingston (eds), 1973, Surgical Approaches in Psychiatry, Lancaster.