Munchausen syndrome: a case report and review of the literature.
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Biomedical subjects
Publications and source records attributed to A M Rouchell.
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Of the initial group of 38 patients in whom we have used cerebellar stimulation for treatment of intractable behavioral pathology, 25 continue to have beneficial effects. However, there have been significant technical problems due to failure of the equipment. While impairing treatment, these complications have provided inadvertent controls. The procedure must still be considered developmental at this time, despite promising therapeutic efficacy.
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Thirty-eight patients who were intractably ill with a variety of behavioral disorders have been treated at Tulane with a chronically implanted cerebellar pacemaker. Included in the series ara schizophrenics, depressives, epileptics with behavioral pathology, and patients with severe organic brain pathology. The patients who have responded best to the treatment are those with depression, those with behavioral pathology consequent to epilepsy, and those with psychotic behavior consequent to structural brain damage. Results obtained in the chronic schizophrenic patients have been less favorable. The follow-up period ranges from a few months to 27 months. Overall, the results continue to be encouraging. Twenty-one percent of the patient group displayed structural evidence of cerebellar pathology that was not detected before operation, a finding which suggests that cerebellar damage may induce psychotic behavior.