Bilateral stereotactic amygdalotomy for self-mutilation disorder. Case report and review of the literature

Bilateral stereotactic amygdalotomy for the management of patients with severe aggressive behavior disturbances was first introduced by Hideki Narabayashi in 1961. Since then, more than 500 cases have been reported in scientific literature, with a variety of cited behavior improvement rates. The advances of psychopharmacology along with the existent skepticism of the medical community in regards to psychosurgery have resulted in a dramatic decrease in the number of amygdalotomies performed worldwide. In our current communication, we report a case of bilateral stereotactic amygdalotomy for a medically refractory self-mutilation disorder. We also review the pertinent literature with an emphasis on the selection of the most appropriate anatomical targets, the procedure-related complications and the outcomes of this occasionally helpful procedure.