Format

Send to

Choose Destination
Gac Med Mex. 2019;155(Suppl 1):S62-S69. doi: 10.24875/GMM.19005128.

[Efecto de la amigdalotomía e hipotalamotomía unilateral en pacientes con agresividad refractaria].

[Article in Spanish; Abstract available in Spanish from the publisher]

Author information

1
Servicio de Neurología y Neurocirugía, Hospital General de México "Dr. Eduardo Liceaga", México.
2
Servicio de Neurocirugía y Neurología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México.
3
Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.
4
Coordinación de Neurociencias, Universidad Anáhuac, Ciudad de México, México.
5
Servicio de Psiquiatría, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México.
6
Higiene Mental, Secretaría de Salud, Ciudad de México, México.
7
Servicio de hospitalización, Hospital Psiquiátrico Fray Bernardino Álvarez, Secretaría de Salud, Ciudad de México, México.
8
Servicio de Neurocirugía, Hospital Regional 110, IMSS, Guadalajara, Jalisco, México.
9
Subdirección de Regulación y Atención Hospitalaria, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México. México, México.

Abstract

in English, Spanish

Background:

Neurosurgical treatment, although controversial, is considered a useful resource in the treatment of chronic psychiatric diseases such as refractory aggressiveness.

Objective:

To evaluate the clinical results and side effects of posteromedial hypothalamotomy associated with amygdalotomy in patients with refractory aggressiveness.

Method:

A clinical trial was conducted in patients with chronic aggressiveness and refractory to pharmacological treatment. A central amygdalotomy associated with posteromedial hypothalamotomy was performed using thermo-coagulation by radiofrequency. The degree of aggressiveness was quantified by the Yudofsky's global scale of aggression. Postoperative changes in aggressive behavior continued to be evaluated every 6 months for at least 36 months.

Results:

A statistically significant change in aggressive behavior was observed during 36 months of follow-up. The collateral effects of the association of both procedures are described, the most frequent being drowsiness and some cases of reduction in sexual behavior.

Conclusion:

Symmetric and simultaneous unilateral lesions of the central nucleus of the amygdala and the posteromedial hypothalamus contralateral to motor dominance give the same clinical effect in the reduction of the pathological aggression that the bilateral lesions.

KEYWORDS:

Aggressiveness; Agresividad; Escala Global de Agresividad; Global Aggressiveness Scale; Limbic System; Neurocirugía Estereotáxica; Psicocirugía; Psychosurgery; Sistema Límbico; Stereotactic Neurosurgery

PMID:
31182879
DOI:
10.24875/GMM.19005128
Free full text

Supplemental Content

Full text links

Icon for Permanyer Publications
Loading ...
Support Center