Bilateral anterior capsulotomy and amygdalotomy for mental retardation with psychiatric symptoms and aggression

RATIONALE Mental retardation (MR) is a chronic condition that often has no readily identifiable cause or treatment. Aggression and psychiatric symptoms are prevalent in children with MR. Surgical treatment of aggression and psychiatric symptoms of MR is seldom investigated and studies are limited. PATIENT CONCERNS We encountered a 19-year-old female who had MR with aggression and psychiatric symptoms. DIAGNOSES She was diagnosed with mild MR with aggressiveness and psychiatric symptoms. INTERVENTIONS Because the patient was refractory to conservative treatment, bilateral anterior capsulotomy and amygdaloid neurosurgery were performed for her psychiatric symptoms and aggression. The benefits and side effects of the surgery were analyzed. OUTCOMES After surgery, the patient showed significant alleviation of her psychiatric symptoms and aggression with no observed side effects. LESSONS Bilateral anterior capsulotomy in combination with amygdaloid neurosurgery may resolve both psychiatric and aggressive symptoms. Future investigations of control studies with large patient cohorts are needed.