Posted by lukeds on November 13, 2006, at 19:08:41
In reply to Re: Has psychosurgery helped anyone? or know someo » Declan, posted by yxibow on November 13, 2006, at 16:49:22
I am totally agree with you. But the psychosurgery is a TABOO cause the abuse of the first psychosurgeons made to a lot of patients, since the Nobel Prize awarded Egas Moniz to many more. And for the people psychosurgery=lobotomy="One Flew Over the Cuckoo's Nest"=BAD, when the truth is that the lobotomy is just one of many types of psychosurgery.
The first procedure
.
The lobotomy prefrontal proposed by Moniz - he made a trepan hole in one area where there are not big glasses and it cut, with a leucotomo, the substance white of the front lobe - it was effective for the treatment of some
alterations of the behavior and the technique you began to extend for all the
countries. With the time, the technique of the front radical lobotomy left
reducing to more restricted leucotomías, although the security of the one
procedure you began to question as they went accumulating data.The operations were made "by hand run off with" with very little control of the size of the
lesion and with a high risk of hemorrhages. Also, this technique was not carried out
with the same seriousness in some places that in others. Most of the times not
they were specialized neurosurgeons those that operated, but neurologists, surgeons
general or even itinerant doctors without any training in the area of
the neurosurgery."In USA, mainly, it was operated without surgical indication any, and it was made
until in traveling régime, as if was a panacea", the doctor Gerardo says Martin, boss of Neurosurgery of the medical center The Operetta of Madrid. Among 1949 and 1952, they were practiced some 5.000 lobotomies a year in USA in these condition. The sick person's selection was only made based on the symptoms. Of way that was not tasted like certain science why it causes it was operating to a patient, and if a patient died I/you/he/she was impossible to know if I/you/he/she had been for the technique in yes or because, for example, there was a cerebral tumor that there was not you
been able to detect.Nevertheless, there were places in those that it was made in a more rigorous way. In Sweden,
for example, the doctor Rylander of Karolinska selected well to those patient and it used a surgical technique very purified with the one that obtained good results and few complications. They were the years 40.
With the time, they were being therapeutic measures - as the shock with
cardiazol, or later the largactil that was the first medication that it controlled some aspects of the mental illness and that it relaxed them a lot-, and the psicocirugía left restricting.However, it continued there being sick
desperate that didn't respond to the treatment that you/they suffered a lot that you
they committed suicide that made homicides, etc.
In Sweden, at the end of the years 50, the doctor's team Leksell - inventor of the one
"gamma knife", a variant of the radiotherapy but for the brain - he/she carried out a
I study very promising. He/she made a group of 60 patients to those that it operated with one
revolutionary technique: the estereotaxia. Instead of having to open up, that that you
he/she made it was to put an electrode of a millimeter and to make clottings in a small one
volume intracraneal located in a critical point.This way, the size of the lesions decreased in an important way - of several centimeters to some few millimeters - and the colateral effects were minimum.
Before, to arrive to a concrete area of the brain with the purpose of "cutting"
determined fibers that cause the symptom supposed, literally, to cross the
area of the previous brain to the lesion. That is to say, to provoke dysfunctions in the rest
of the brain. However, the technical estereotáxica, with a sophisticated system
of coordinated, it allowed to direct the "shot" to the exact place in the one that you
he/she wanted to intervene.In Spain, the first psychosurgeries was made in the year 1966. The doctor
Juan Antonio Burzaco, of the Service of neurosurgery of the Hospital Ruber
International of Madrid that Leksell was working with the doctor in Sweden,
he/she took charge, together with the doctor López Ibor, of the first cases in the one
Clinical Hospital of Barcelona. And, nowadays, with 30 years of experience in
this field and about 360 operated patients, the doctor Burzaco is, practically,
the only person in Spain that carries out interventions of this type."The first patient that I operated was a 21 year-old girl with neurosis that you
it had cut two or three times times the language in spite of the medication and of
to be entered", the doctor counts Burzaco. From then on, those have appeared
modern diagnosis techniques (the resonance, TAC, PET - that takes
installed in Spain one year -, etc), able to depict the operation and the
it structures of the brain of a patient, they have been medications very
effective and they have advanced a lot the studies of the brain.
Faced opinions.However, there are specialists that say that, with scientific rigor, it is
impossible to come closer to a problem of the mind with a scalpel, because still
it is a lot to discover in what refers to the cerebral connections. It is
the case of the doctor Francisco Lives, professor of the Department of Physiology
Human of the Ability of Medicine of the University of Alcalá De Henares of Madrid that
it sustains that there is not any foundation experimental clearing of what you is
making in psicocirugía. It is "as killing flies to gunshots", he/she says the one
neurologist.But, on the other hand, today there is still a number of upset sick persons that you/they have
that to be tied to the bed because they don't respond to any medical treatment and
the colateral effects of the quantity of fármacos that have to take are
worse than to have them fellows. Other, in spite of the medication, they are cases
exasperating that they try to constantly commit suicide and they have stayed
paralytics, or almost, in the intent; or you automutilan, sometimes being provoked the
death; or they are aggressive, violent individuals, or in those that the suffering is
harrowing and constant. They are sick irreversible, chronic, very serious, for
those that the psicocirugía is the last alternative that they have left to prove for
to put an end to the nightmare. However, this specialty continues being the center
of all the critics in the Congresses of Psychiatry. "Only to speak of this
fear, you burn - the doctor Martin says that sporadically also carries out
operations of this type -.But this whole climate goes back to the history that
each one counts to their way, and to the bad practice that was made before the 50."
According to the doctor Burzaco, many specialists rush critical against the
psicocirugía without having never seen a patient or without having revised the
bibliography to analyze the results. It is "as to see the reality and to refuse to
to accept it", he/she says. In a World Congress of Biological Psychiatry taken place in
Stockholm at the beginning of the 80 came out to it floats some hard ones critical during
the course of a round table dedicated to the treatment of the aggressiveness
pathological.I "proposed that comes to Madrid that sees the files of those
people that we have operated, because they are public, and that after seeing them
they could say. Meanwhile, the only thing that is achieved is to convert a meeting
scientific in a political" mítin, Burzaco says. Some psychiatrists allege that
it is a he/she arms of double edge that could be used against the political prisoners,
against the women, against the children. However, according to Burzaco that argument
it is not scientific and you can apply everything, not only to the psicocirugía. "A
knife you can use to give the life or to give the death - he/she says
Burzaco -.And two hours of television they have ended up harming more than a
neurosurgeon in all their life. What happens is that the mysterious thing or that that not
we know it seems always dangerous."
"Nowadays, in the world psicocirugías is making in those that PET
it shows the cerebral operation clearly before and after the operation and
he/she is proven how the patient's situation has been normalized - he/she says the one
specialist -. And one has seen how a girl of 20 or 21 years that it took from
the 14 suffering a neurosis, he/she becomes a free woman and without complex
after the intervention." According to the doctor's data Burzaco, in a valuation
carried out recently with the operated patients of psicocirugía in Spain,
70% of the sick persons had improved in an important way and, with or without
medication, they could make a normal life.
20% improved, although not enough. And 10% to hardships modified.The doctor Enrique Ferrer, boss of the service of neurosurgery of the Clinical Hospital
of Barcelona, he/she doesn't doubt that "this surgical technique will return. Because when
it is very suitable, the psicocirugía offers some very correct results. Without
I levy, now it is a so much discredited, and the psychiatrists don't usually think
in her like a solution for their patients."
On the other hand, all the specialists not omen him/her so good future to this
procedure. The doctor Francisco Lives he believes that "as we advance in the one
knowledge of the brain will go separating the coarse thing, and the coarse thing is the
psicocirugía."For the doctor Martin, although today the indications have lowered a lot, "the
psicocirugía has never died and it has never been stopped to practice." The group of the one
Massachusetts General Hospital, in Boston, he/she has not stopped to make a surgery
of the system límbico called cingulotomía estereotáxica to treat those
patient obsessive compulsive that don't respond to the pharmacology, and others
psychiatric problems.Greetings. lukeds.
poster:lukeds
thread:701741
URL: http://www.dr-bob.org/babble/20061110/msgs/703229.html