FORNIKOTOMYYa (Latin fornix the arch + Greek tome a section, a section) — the stereotaxic operation consisting in destruction of conduction paths in the arch of a brain from one or both parties.
The purpose of operation — interruption patol. impulsation, in particular the epileptic category, in limbic system (see). T. often combine with an amigdalotomiya (see), destruction of front commissure. Indications to operation — temporal epilepsy (see) with psychomotor attacks, aggression, psychomotor excitement. H. Nara-bayashi considers that F. it is shown at psychomotor, and an amigdaloto-miya — at generalized convulsive attacks. According to Su-gity (To. Sugita) and sotr. (1971), T. gives the most expressed effect at emotional disturbances, smaller — at psychomotor and smaller — at generalized attacks. T. it is contraindicated at cortical focal attacks.
Operation is carried out, as a rule, under local anesthesia. Coordinates of a point of the purpose determine by the stereotaxic atlas (see. Stereotaxic neurosurgery) also destroy a middle part of the arch on 3 mm of a kzada from front commissure. The size of a zone of destruction shall not exceed 5 mm in the diameter. Destruction can be carried out by means of controlled coagulation or methods of a cryosurgery (see). Bilateral F. make at the same time or at an interval of several weeks.
According to Sugita and sotr., at 36% of patients after operation disappearance of epileptic seizures, at 43% — moderate improvement is noted; at 21% of patients the effect was absent. G. Bouchard at 65% of the patients who transferred F., noted reduction of generalized attacks, at 62% — reduction of small temporal attacks; disturbances of mentality became less expressed at 51% of patients.
Among complications passing disturbances of memory, disorder of orientation, a polyphagia are noted, to-rye are observed approximately in 1% of cases.
Bibliography: Kandel E. I. Funk
tsionalny and stereotaxic neurosurgery, page 289, M., 1981; Special topics in stereotaxis, ed. by W. Umbach, Stuttgart, 1971. O. A. Laponogov.