Is the Lobotomy Performed Today?

The short answer is yes, but almost never for mental disorders. It is mostly used for epilepsy. Shockingly, surgeons use lobectomy too (the removal of the frontal lobe or lobes). Other brain operations like amygdalohippocampectomy are used as well. Psychosurgery.org reserves judgment on these treatments because we have not heard anything either positive or adverse from the families of these patients (please contact us if you have information you’d like to share). Below is a tiny sample of the literature from PubMed. Again, due to copyright restrictions I can only post titles and abstracts with a link to the publisher who sells them.

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Temporal lobotomy in the surgical management of epilepsy: technical report. Smith JR, VanderGriff A, Fountas K.

Department of Neurosurgery, Medical College of Georgia, Augusta, Georgia.

OBJECTIVE: To describe the technique of temporal lobotomy and demonstrate that it may produce results equivalent to anterior temporal lobectomy in the control of drug-resistant complex partial seizures of anterior temporal lobe origin. METHODS: Patient selection and evaluation was similar to that for other patients undergoing anterior temporal lobectomy, with the exception that the 10 selected patients all demonstrated extensive lobar or hemispheral atrophy on magnetic resonance imaging or computed tomographic scans. The lobotomy technique involved posterior and superior disconnection, each of which was broken down into lateral and mesial components. RESULTS: At last follow-up, seven patients were seizure-free, one had rare seizures, and two had a less than 90% decrease in seizures. These outcomes are similar to those in our overall temporal lobectomy series. One patient who underwent left-sided temporal lobotomy had a speech fluency deficit postoperatively. CONCLUSION: Temporal lobotomy seems to be an effective disconnective procedure in the treatment of drug-resistant temporal lobe epilepsy. Larger series will be needed to better define its role in the management of this condition.

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Excessive masturbation after epilepsy surgery. Ozmen M, Erdogan A, Duvenci S, Ozyurt E, Ozkara C.

Consultation-Liaison Division, Department of Psychiatry, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. drozmen@superonline.com

Sexual behavior changes as well as depression, anxiety, and organic mood/personality disorders have been reported in temporal lobe epilepsy (TLE) patients before and after epilepsy surgery. The authors describe a 14-year-old girl with symptoms of excessive masturbation in inappropriate places, social withdrawal, irritability, aggressive behavior, and crying spells after selective amygdalohippocampectomy for medically intractable TLE with hippocampal sclerosis. Since the family members felt extremely embarrassed, they were upset and angry with the patient which, in turn, increased her depressive symptoms. Both her excessive masturbation behavior and depressive symptoms remitted within 2 months of psychoeducative intervention and treatment with citalopram 20mg/day. Excessive masturbation is proposed to be related to the psychosocial changes due to seizure-free status after surgery as well as other possible mechanisms such as Kluver-Bucy syndrome features and neurophysiologic changes associated with the cessation of epileptic discharges. This case demonstrates that psychiatric problems and sexual changes encountered after epilepsy surgery are possibly multifactorial and in adolescence hypersexuality may be manifested as excessive masturbation behavior.