The Origins of Human Functional Stereotaxis: A Reappraisal

Stereotact Funct Neurosurg. 2019;97(1):49-54. doi: 10.1159/000496157. Epub 2019 Feb 13.

Abstract

In order to shed light on the first application of human functional stereotactic neurosurgery, whether it was in the realm of movement disorders, as has been claimed repeatedly, or in the realm of psychiatry, a review of the original scholarly literature was conducted. Tracking and scrutinising original publications by Spiegel and Wycis, the pioneers of human stereotactic neurosurgery, it was found that its origin and the very incentive for its development and first clinical use were to avoid the side effects of frontal leucotomy. The first applications of functional stereotactic neurosurgery were in performing dorsomedial thalamotomies in psychiatric patients; it was only later that the stereotactic technique was applied in patients with chronic pain, movement disorders and epilepsy. Spiegel and Wycis' first functional stereotactic operations were for obsessive-compulsive disorder, schizophrenia, and other psychiatric conditions.

Keywords: Functional neurosurgery; History; Leucotomy; Psychosurgery; Stereotactic surgery; Stereotaxy; Thalamotomy.

Publication types

  • Review

MeSH terms

  • Chronic Pain / diagnostic imaging
  • Chronic Pain / surgery
  • Epilepsy / diagnostic imaging
  • Epilepsy / surgery
  • Humans
  • Movement Disorders / diagnostic imaging
  • Movement Disorders / surgery
  • Nervous System Diseases / diagnostic imaging
  • Nervous System Diseases / surgery*
  • Neurosurgery / methods
  • Neurosurgery / trends*
  • Obsessive-Compulsive Disorder / diagnostic imaging
  • Obsessive-Compulsive Disorder / surgery
  • Psychosurgery / methods
  • Psychosurgery / trends
  • Stereotaxic Techniques / trends*