Stereotactic Surgery of the Limbic System in Epilepsy

Abstract

This paper analyses the various targets in the limbic system, the elimination of which has a beneficial effect on epilepsy. We prefer to include the amygdala, certain nuclei in the hypothalamus and the internal medullary lamina in this “so-called limbic system”. The reasons for inclusion of these under one title of behavioural brain have been published in our earlier papers ^{2, 4}. Under the broad term epilepsy we propose to discuss many varieties of paroxysmal disorders. These will be detailed in the course of our analysis. It has to be pointed out at this stage that practically all the targets were eliminated only with one main idea and that was to control the various behavioural phenomena. These behavioural phenomena were either continuous or (only in some cases) episodic—the latter conforming to a grouping under temporal lobe or psychomotor seizure. The patients were brought in for the behavioural disorders and the surgery was performed only for this. These cases were operated upon from 1964 and are being followed up regularly to date, i.e. 1975.

We thank Prof. B. Ramamurthi, Director, Institute of Neurology, Madras, and the Superintendent, Government General Hospital, Madras, for giving permission to present this paper. We thank the Neurologists Prof. G. Arjundas, Prof. K. Jagannathan, and Dr. C. U. Velmurugendran who read and reported on the EEG.