Amygdaloid neurosurgery for aggressive behaviour, Sydney, 1967-1977: chronological narrative.

Objective: The aim of this paper is to record an historical narrative of amygdaloid neurosurgery at Callan Park Mental Hospital, Sydney in the period 1967-1977. In this paper, this is denoted the Amygdaloid Neurosurgery Project (ANP). The goal of the project was to ameliorate aggressive or self-harming behaviour by selective ablative surgery on the amygdaloid nucleus.

Conclusions: In 1964, Professor Leslie Gordon Kiloh became acting director of the newly built neurosurgical research facility at Callan Park Mental Hospital. In 1966, he advised bilateral amygdaloidotomy for the treatment of a 16-year-old aggressive and self-harming male patient. Following major improvement in that patient's condition, a further 19 patients were treated by amygdaloid surgery. In 1974, Kiloh's team reported that 39% of the first 18 patients treated had persisting improvement but one patient sustained persisting hemiplegia. The program was suspended in 1977 by the New South Wales (NSW) Government, following allegations by a senior nurse that patients at the neurosurgical unit had been mistreated. A Ministerial Committee of Inquiry proposed that stringent legislative controls should be applied to psychosurgery. The Committee expressed reservations about amygdaloid psychosurgery in particular. Psychosurgery referrals declined after that date. Since 2007, under the revised NSW Mental Health Act, all forms of neurosurgery for psychiatric disorder are prohibited.