Lobotomy and Epilepsy

Abstract

622 patients subjected to prefrontal lobotomy have been followed for a minimum of 2 years and some for more than 15 years. For comparison, a group of 498 patients treated by transorbital lobotomy was included in this study. Various factors such as preoperative shock therapy, preoperative convulsive seizures, operative complications, complicating organic brain disease, and especially multiple lobotomies were analyzed. Finally an effort was made to determine the effect of the locus of operation upon convulsive seizures after lobotomy. It was found that convulsions following lobotomy were more common in males and at younger ages. Social status, degree of social achievement, and preoperative shock therapy had little significance, and the presence of somatic disease and different types of mental disease had no significant effect. All these factors were much less significant than actual brain injury. Prefrontal lobotomy had an overall incidence of 24% and transorbital lobotomy 1%. Multiple lobotomies resulted in 53% convulsions after prefrontal lobotomy and 3% after transorbital lobotomy. There was some increase in convulsive seizures in prefrontal lobotomy closer to the motor cortex. Paradoxically, an occasional case was found in which preoperative epilepsy was alleviated by lobotomy.