Stereoencephalotomy.

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Abstract
The stereotaxic technique has been applied to the human brain. For relief of mental disorders with a prevalent emotional component, lesions have been placed bilaterally in the dorsomedial nucleus of the thalamus (dorsomedial thalamotomy) in order to interrupt the cortico-diencephalic connections probably related to the mechanism of emotions (16 cases). Lesions covering about 1/7 of the volume of this nucleus on each side have been able to produce relief of nervous tension, anxiety, depression, irritability, agitation, hallucinations or complusions; this has been obtained without at least some of the undesirable by-effects of prefrontal lobotomy such as epi-leptiform convulsions, childishness, facetiousness, distracti-bility, lack of tact or discipline. For relief of intractable pain, a lesion of the long ascending pain-conducting pathways in the midbrain has been combined with a lesion of the dorsomedial nucleus (mesencephalothalamotomy). In epileptics suffering from grand and petit mal, the electrothalamogram was recorded, revealing spike discharges; lesions placed in the vicinity of the commissura media (paracommissural thalamotomy) diminished, at least transitorily, the frequency and severity of the petit mal attacks.

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