New forms of Amygdalectomy. Less tissue, less risk:
Amygdalectomy (partial or total) is a clinically safe and experienced ablative surgical procedure
(< 0,1% mortality), carried out since 1960, and performed today with mini invasive and selective
methods with less tissue removal (< 2,0 cubic cm) compared with other kinds of ablative procedures
(> 5 cubic cm). It’s used in various resistant pathologies
(focal epilepsy, intract. aggressivity, autism, etc.).
Despite inadequate efficacy of actual therapies for Panic Disorder, Agoraphobia and other Stress neurological disorders,
and despite converging evidence on amygdala, there’s still not a specific drug or surgical procedure
on amygdala for the resolution of those diseases. After all, the old DSM IV (2013)
still categorized Panic and Agoraphobia as a subtype of Anxiety Disorders. Now DSM V is changed
because of last 20 years of scientific studies demonstrating that
“Anxiety” and “Panic” are different types of emotions (“sustained fear” and “phasic/acute fear”)
involving different areas and different functional brain connectivity.
For Example, a recent study on mammals (Langevin2013) shows how DBS on the amygdala inhibits panic but not anxiety behaviors, while paroxetine works for anxiety but has no significant results in panic.
We can hypothesize some reasons why we don’t help people with dramatic panic disease:
less danger to society (intractable aggressivity, major depression, schizophrenia, OCD)
less visual and emotional impact (differently from epilepsy, etc..)
no empathy, comprehension and social support for these people, finding themselves suddenly alone, fragile, and unexpectedly overcomed and subjugated by the illness - more..
Medicine and common sense require to evaluate the illness from the viewpoint of
how it affects the patient's quality of life, and not merely considering the social dangerousness
and visual impact.
Then again, when a person can’t go out of home, breathe open air, feel the sun on the skin,
adequately work, grow his children, participate to society, play a sport, study,
socialize (and much other contributing to physical and mental wellness) ..
then you can easily understand how “severe” is the illness.