Stereotaxic anterior cingulotomy for neuropsychiatric illness and intractable pain.

I N THE 30 years since Egas Moniz 6,7 published his first reports, thousands of pat ients have undergone frontal lobe surgery for men ta l illness. Recent reports 1a,17,Is indicate t h a t about two-thirds of operated pat ients are benefited by frontal lobotomy, bu t serious side effects of operation have been noted in some of the unimproved group. There has been, therefore, a continuing search for a procedure which might be simpler, more effective, and safer. We are repor t ing a series of 57 neuropsychiatr ic pa t ients in whom bilateral radiof requency lesions were placed stereotaxically in the anter ior cingulum. We have witnessed an encouraging degree of improvement in psychiatr ic s y m p t o m s and no serious operat ive or pos topera t ive complications. We have also performed cingulotomy to relieve the int ractable pain of incurable cancer, bu t the 12 pat ients in this series are reported primarily in reference to the over-all surgical results and certain pre l iminary information obtained a t au topsy relat ive to the size and anatomical p lacement of the lesions.