Modified Frontal Leucotomy: A Review of 106 Cases

Abstract

Frontal leucotomy has been used in the treatment of psychiatric illness for over twenty years. Its popularity has undergone the usual fluctuations of a newly-introduced form of empirical therapy, and at present there are many different opinions about its value (Lancet, 1962; Pippard, 1962). For a critical review of the clinical and psychological literature, see Willett (1960). The standard operation has fallen out of favour, not because it was thought to be ineffective, but because it had undesirable side-effects on the personality. Various “modified” operations have, therefore, been introduced. Using one of these—the “orbital undercutting” technique—Knight (1960) has reported excellent results in 129 cases of long-standing depression. Robin (1958, 1959), however, has reported no difference between the outcome for 198 patients who had a standard leucotomy for functional psychoses, fifty-two of them affective, and an equal number of carefully but retrospectively matched controls.