Prefrontal Lobotomy
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A prefrontal lobotomy was a neurosurgical procedure intended to treat mental disorders like schizophrenia by disconnecting the prefrontal lobes from the rest of the brain. Dr. Moniz performed the first lobotomy in the 1930s and Dr. Freeman popularized the procedure further in the 1940s-1950s. Lobotomies were performed on patients with chronic anxiety, tension, or schizophrenia who had not responded to other treatments like electroconvulsive therapy. The procedure involved making incisions in the skull and using a tool to cut connections in the prefrontal region of the brain. Studies found lobotomies often reduced symptoms but also caused personality changes like increased psychopathic behaviors and a loss of concern over previous conditions or
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Neuropsychiatric Manifestation In 8 Years Old Girl Presented With Obstructive...
This document summarizes a case report of an 8-year-old girl presenting with obstructive hydrocephalus secondary to a posterior fossa tumor. She exhibited neurological symptoms like lower limb weakness and worsening headaches, as well as psychiatric symptoms including hallucinations and delusions. Imaging showed a tumor in the posterior fossa and ventriculomegaly. Posterior fossa tumors can cause hydrocephalus by disrupting cerebrospinal fluid flow. While psychiatric issues are common post-resection, they can also arise from brain changes caused by the tumor. The patient's symptoms were likely due to the mass effect of the tumor and associated hydrocephalus.
Rosenhan overview
Rosenhan conducted a famous study where sane individuals successfully gained admission to psychiatric hospitals by feigning auditory hallucinations. All were diagnosed with schizophrenia and their normal behavior was misinterpreted by staff. In a follow up study, hospital staff also could not distinguish real patients from those falsely claimed to be admitted. The study highlighted the depersonalization and powerlessness felt by patients when subjected to psychiatric labels and institutionalization rather than community-based care focused on behavior.
Isolated Cerebellar Stroke Masquerades as Depression
Two case reports illustrate how isolated cerebellar stroke can masquerade as depression. In both cases, patients presented with vertigo and were initially misdiagnosed with depression due to seeming uncooperative behavior. Further examination revealed neurological deficits and imaging showed infarcts in the cerebellum. Cerebellar stroke can cause severe vertigo, nausea, and inability to walk that mimic depressive symptoms. However, the acute onset and lack of mood changes suggest an organic cause. Physicians must consider cerebellar stroke and fully examine for neurological signs when vertigo is present to avoid misdiagnosing potentially life-threatening conditions as psychiatric disorders.
Few list of neuropsychiatric disorders
The neuropsychiatric disorders enhance widely if not cared for properly. A few of the neuropsychiatric disorders which should be taken care of are included here.
430 Chapter 17 Death and DyingCase 17-1When Parents Refu.docx
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Case 17-1
When Parents Refuse to Give Up1
Nine-year-old Yusef Camp began experiencing symptoms soon after eating a pickle bought
from a street vendor. He felt dizzy and fell down, he could not use his legs, and he began
to scream. By 10:00 p.m., he was hallucinating and was transported to the DC General
Hospital by ambulance. He went into convulsions. His stomach was pumped, and they
found traces of marijuana and possibly PCP. He soon stopped breathing, and by the next
morning, brain scans showed no activity.
Four months later, Yusef’s condition had not changed. The physicians believed his brain
was not functioning and wanted to pronounce him dead based on brain criteria. Several
difficulties were encountered, however. First, there was some disagreement among the
medical personnel over whether his brain function had ceased completely. Second, at that
time the District of Columbia had no law authorizing death pronouncement based on
brain criteria. It was not clear that physicians could use death as grounds for stopping
treatment. Most important, Ronald Camp, the boy’s father, protested vigorously any sug-
gestion that treatment be stopped. A devout Muslim, he said, “I could walk up and say
unplug him; but for the rest of my life I would be thinking, was I too hasty? Could he have
recovered if I had given it another 6 months or a year? I’m leaving it in Almighty God’s
hand to let it take whatever flow it will.”
The nurses involved in Yusef’s care faced several problems. Maggots were found
growing in Yusef’s lungs and nasal passages. His right foot and ankle became gangre-
nous. He showed no response to noises or painful stimuli. The nurses had the responsi-
bility not only for maintaining the respiratory tract and the gangrenous limb, but also for
providing the intensive nursing care needed to maintain Yusef in debilitated condition
on life support systems. Had the aggressive care been serving any purpose, they would
have been willing to provide it no matter how repulsive the boy’s condition was and in
spite of there being many other patients desperately needing their attention. However,
some of the nurses caring for Yusef were convinced that they were doing no good what-
soever for the boy. They believed they were only consuming enormous amounts of time
and hospital resources in what appeared to be a futile effort. In the process, other
patients were not getting as much care as would certainly be of benefit to them. Could
the nurses or the physicians argue that care should be stopped because he was dead?
Could they overrule the parents’ judgment about the usefulness of the treatment even
if he were not dead? Could they legitimately take into account the welfare of the other
patients and the enormous costs involved when deciding whether to limit their atten-
tion to Yusef?
1Weiser, B. (1980, September 5). Boy, 9, may not be “brain dead,” new medical examiner
shows. Washington Post, ...
PNES/functional neurology CME AKUH Nairobi 12th January 2015
PNES/functional neurology CME AKUH Nairobi 12th January 2015Aga Khan University Medical College of East Africa
This document outlines Dilraj S. Sokhi's presentation on neurological manifestations of psychological problems. It discusses transient loss of consciousness (TLOC), psychogenic non-epileptic seizures (PNES), medically unexplained symptoms (MUS), and cognitive behavioral therapy (CBT). The presentation describes the differences between epileptic and non-epileptic seizures, predisposing and precipitating factors for PNES, diagnostic tools like video EEG, and the importance of correctly diagnosing and explaining PNES to patients. It emphasizes treating the whole patient using a biopsychosocial model and mentions the recognition and management of PNES may be important in Kenya given psychological comorbidities in the population.Schizophrenia
The document discusses the history of schizophrenia from ancient times to modern day. It describes how schizophrenia was first identified as a distinct mental illness in 1887 by Emil Kraepelin. The term "schizophrenia" was coined in 1911 by Eugen Bleuler to describe symptoms of fragmented thinking and perception. It also provides statistics on the prevalence of schizophrenia and discusses potential causes like genetics, brain abnormalities, and environmental factors.
approach to first seizure.pptx
This document provides an overview of approaches to evaluating and diagnosing patients presenting with their first seizure. It discusses determining whether the event was truly a seizure, if epilepsy is likely, the seizure type, and underlying cause. A thorough history and physical exam is important. Testing like MRI, EEG can help determine risk of recurrence but often don't need to be done for a first unprovoked seizure unless certain risk factors are present. The risk of a second seizure after the first is about 33%, rising to 76% after a second seizure, so treatment is usually only considered for those at higher risk. Several case examples are provided and discussed.
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Prefrontal Lobotomy
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