General
- There is no evidence that personality disorders, anorexia nervosa, or schizophrenia respond to lesional neurosurgery and these patients should not be considered unless the aim of the surgery is restricted to chronic intractable affective or obsessional comorbid symptoms.
- Difficulties can arise in determining the suitability of patients where illness onset was at a sufficiently early age to have had an adverse impact on personality development.
Decision for surgery
- Secure diagnosis
- Ability to provide informed consent.
- Following MDT discussion: consideration of the potential costs and benefits to the individual on a case-by-case basis by the multidisciplinary team.
CI
- Affective or obsessional symptoms due to active organic or degenerative brain disease, #
- Pervasive developmental disorder is likely
- Although cerebrovascular disease or pre-existing epilepsy is not an absolute contraindication
- Patient is not fit for surgery because of a tendency to bleed, local infection, or a high anesthetic risk.
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