前頭脳部分切除例の精神症状の長期観察

STUDIES ON FIVE YEARS FOLLOW-UP OF FRONTAL LOBECTOMY (IN PSYCHIC SYMPTOMS)

　1．前頭脳部分切除を行つた精神薄弱兼癲癇1例及び精神分裂病8例の計9例について，術後4〜7年にわたつて臨床的に観察し，かつ術後4〜5年の時に行つた心理検査（Wechsler-Bellevue知能テスト，Kraepelin・内田作業素質検査，Bender-Gestaltテスト及びRorschachテスト）の結果と合わせて，手術による精神症状の変化を論じた。

　2．治療効果として，発病以来数年ないし十数年を経過し，諸種療法に殆んど効果のなかつた暴行，刺激性，拒絶症等の症状を消失あるいは著しく軽減せしめた。また幻覚，妄想等の異常体験症状も症例の一部で軽減消失せしめる効果を認めた。精神薄弱兼癲癇の1例においては上記の他に，痙攣発作の完全な消失を，同性愛行為の著しかつた1例ではその消失を認めた。症状変化の時間的関係については一定傾向を見出せなかつた。これ等の転帰は不全寛解3，軽快3，未治3と判定された。

　3．一般に術後のいわゆる前頭脳症状の出現は著しくなく，心理検査の上でも器質的脳損傷の所見はLobotomyを受けた症例の対照群との比較でも特に著しくなかつた。しかしWechsler-Bellevueテストにおける注意障碍は特異的であつた。I，Q．の手術による低下は認められなかつた。

1. One case of mental deficiency with epi-lepsy and eight cases of schizophrenia per-formed the partial resection of frontal brain (frontal lobectomy) were observed during 4-7 years after operations. The changes of psychic symptoms were investigated clini-cally and psychometrically.

2. The operated patients who had passed many years since their outbreaks, showed marked violences, excitements, and nega-tivisms etc. before the operation without remarkable effects of various treatments. We recognized definite effect of the opera-tion, i. e. the above mentioned symptoms generally disappeared or markedly decreased and sometimes pathological experiences such as delusions, hallucinations etc. also disa-ppeared. We also recognized irreversible dis-appearance of epileptic seizures in the first case. Manifest homosexual acts disappeared postoperatively in one case. Three of them could attain to incomplete recovery.

3. Gennerally, postoperative appearance of so-called frontal syndromes were not remar-kable. The signs of organic brain damage on the several psychological tests such as Wechsler-Bellevue Test, Bender-Gestalt Test, and Rorschach Test etc.