What Is a Lobotomy and Why Is It Rare Now?

An Outdated Type of Brain Surgery

Medically reviewed by Nicholas R. Metrus, MD

A lobotomy is a variety of brain surgery that involves the removal or cutting of a portion of the brain, normally for the aim of treating a mental health condition. This medical procedure was never a standard variety of treatment, and it was primarily used between the Nineteen Forties and the Nineteen Sixties.

Lobotomies were sometimes protected and effective for treating psychiatric disorders but often caused substantial hostile effects, including significant changes in personality and lack of independence.

Lobotomy is not any longer utilized in the United States to treat mental health conditions. Many protected and effective therapies can treat mental health disorders, including medication, psychotherapy, and minimally invasive surgical interventions, corresponding to using electrical stimulation to assist alleviate symptoms of mental health conditions.

What Is a Lobotomy Exactly?

“Lobotomy” is defined because the removal of a number of of the lobes of the brain, however the term has been used to explain transection (cutting) regions of the brain for the treatment of psychiatric conditions corresponding to schizophrenia or major depressive disorder.

When lobotomy was used to treat psychiatric disorders, the procedure involved the removal or transection of a part of the frontal lobe of the brain, which is the a part of the brain that controls personality and behavior.

Lobotomy is a serious brain surgery that requires access to the brain tissue through either a burr hole (a hole that’s drilled into the skull) or craniotomy, which is cutting or lifting away a part of the skull to acquire access to the brain tissue. A lobotomy is a high-risk surgical treatment that could be life-threatening.

When these procedures were done, individuals who survived a lobotomy could potentially experience fewer psychiatric symptoms, corresponding to delusions (irrational beliefs that are usually not true) in consequence of the surgery. But unwanted effects included significant personality changes and diminished ability to manage their behavior and actions.

Related: Frontal Lobe Damage: Symptoms, Causes, and Treatments

Are Lobotomies Still Performed Today?

According to historians, lobotomy was pioneered in 1936 by Portuguese neurologist António Egas Moniz. The practice spread to other parts of Europe, in addition to the United States. At the time, it was considered a breakthrough that might help individuals with severe psychotic disorders.

As effective antipsychotic medications emerged and the hazards of lobotomy raised ethical concerns, the procedure became less common. Lobotomy, because it existed, just isn’t accepted as a treatment within the United States today.

Many neurosurgical procedures involve the removal or resection of brain tissue, but these are done very in another way than psychiatric lobotomy. For example, resection of tumors and cancer from the brain is a lifesaving surgery.

Some sorts of brain surgery to treat epilepsy or movement disorders involve the removal or resection of brain tissue to stop seizures or movement disorder symptoms from occurring.

Related: Frontal Lobotomy and Medical Ethics

Why Were Lobotomies Performed?

Lobotomy was performed to cut back symptoms of mental health conditions, primarily schizophrenia and major depressive disorder. The procedure decreases a few of the nerve communication within the frontal lobe of the brain, which may prevent the behaviors that result from these mental health disorders.

According to the medical documents, some individuals who survived a lobotomy experienced an improvement in psychiatric symptoms. However, these people didn’t experience a healthy quality of life or maintain independent self-care. Medical records also indicate that these procedures were dangerous and that many individuals didn’t survive.

What Lobotomies Do to People?

Lobotomy changes the best way people function, often resulting in diminished awareness and interactions. People who underwent lobotomy were found to have reduced cognitive (pondering, problem-solving, and reasoning) abilities, in addition to impaired emotional responses.

As with any variety of brain surgery, there may be a risk of edema (brain swelling), infection, bleeding, unintentional damage to the brain, disability, or death.

Today, lobotomy just isn’t considered an ethical intervention. However, a long time ago, it was seen as a possible solution for individuals with severe mental illness.

It even was considered to be a medical advancement and a more humane treatment than earlier ways of coping with mental illness—which had included approaches corresponding to placing people in isolation.

Can a Person Survive After Lobotomy?

The answer as to if an individual can survive a lobotomy is possibly. In the past, some people survived after lobotomy, but many died on account of complications.

Brain surgery often relies on monitoring that may help pinpoint areas of the brain that have to be removed or transected. This variety of monitoring may help locate areas of the brain which can be involved in crucial functions, corresponding to language and mobility, to cut back the chance of hostile effects.

Medical Treatments Preferred Over Lobotomies Today

Psychiatric look after mental health conditions has improved substantially over the past 100 years. Advances in psychiatric treatments have yielded many treatment alternatives which can be far safer and more practical than lobotomy. Psychosurgeries are rarely used today.

Common treatments for psychiatric disorders include:

• Antipsychotics and other medications: Medications that may help treat psychiatric disorders include first- and second-generation antipsychotics, atypical antipsychotics, antidepressant medications, and antianxiety medications.
• Psychotherapy: Psychotherapy involves talking with an expert who’s trained in diagnosing mental health disorders and providing techniques for managing mood, gaining insight into behaviors, learning tips on how to control responses, and coping with symptoms corresponding to delusions and hallucinations.
• Hospitalization: In some situations, mental health symptoms could be harmful and dangerous to an individual’s health. A period of hospitalization with medical supervision and medicine may help in stabilization and making a long-term treatment plan.

Psychosurgeries Used Today

With advancements in psychotropic medications, psychosurgeries are rarely performed. Surgery could be an option in very specific situations, and frequently only after less invasive therapies haven’t been sufficiently effective.

Psychosurgical procedures include:

• Anterior cingulotomy: This procedure targets a small area within the brain that controls sensation. It could also be used as a therapeutic option for chronic pain that’s medication-resistant.
• Ventral capsulotomy: This procedure is used to make a small cut in an area of the brain that controls sensory processing. It could be used as a therapy for treatment-resistant obsessive-compulsive disorder (OCD).
• Subcaudate tractotomy: This procedure involves cutting a small area near the back of the frontal lobe as a therapy for treatment-resistant mood disorders.
• Limbic leucotomy: This procedure targets an area of the brain that controls emotions. It is used to treat medication-resistant depression and obsessive-compulsive disorder.
• Corpus callosotomy: During a corpus callosotomy, the surgeon cuts the corpus callosum, which physically connects the 2 hemispheres of the brain. This procedure stops communication between the left and right sides of the brain. It is used as an intervention for some sorts of treatment-resistant epilepsy.
• Deep brain stimulation: This therapeutic intervention involves the location of a tool that sends electrical impulses to a region of the brain to manage symptoms of depression.

These procedures require extensive presurgical testing to assist pinpoint the situation and to avoid hostile effects.

Learn More: The Anatomy of the Brain

Summary

Lobotomy is an outdated procedure that was used prior to now for the treatment of psychiatric conditions. While lobotomy is not any longer considered protected, the initial introduction of this surgery followed medical protocols of the time.

With advancements and pharmaceutical management and other types of treatment, lobotomy is not any longer utilized in the United States to administer psychiatric disorders. It is dangerous and may cause substantial impairment of a person’s personality and talent to handle themselves.

Other medical treatments may help reduce the symptoms of psychiatric disorders. These include medication, cognitive behavioral therapy, counseling, and surgically implanted devices to manage symptoms. Psychiatric care nowadays relies on diagnostic criteria and treatment protocols.

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