Skip to main content
SpringerLink
Log in

Observations on organic brain damage and clinical improvement following protracted insulin coma

  • Published:
The Psychiatric Quarterly Aims and scope Submit manuscript

Summary

A study of eight cases of chronic schizophrenics who developed protracted coma during insulin shock therapy is reported. Five of the eight patients showed a marked improvement after protracted coma, and three remained unimproved. The improvement consisted of loss of tension and hostility. Patients became friendly, affable, relaxed and interested in the environment. In spite of the return of delusional systems, the improved patients were able to function on a higher level than previously. In four of the five improved patients, improvement was preceded by severe organic brain deficit of varied duration. The organic deficit was demonstration through clinical observation, a battery of psychological tests and electro-encephalograms. Improvement is attributed to the organic brain damage which results in disruption of associative pathways not unlike the disruption in lobotomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Piotrowski, Z. A.: On the Rorschach method and its application in organic disturbances of the central nervous system. Rorsch. Res. Exch., 2:23–40, 1936.

    Google Scholar 

  2. Wells, F. L., and Ruesch, T.: Mental Examiner's Handbook. Pp. 48–52. Psychological Corporation. New York. 1945.

    Google Scholar 

  3. Goldman, Douglas: Prolonged coma after insulin hypoglycemia, clinical features and treatment. J. N. M. D., 92:157, August 1940.

    Article  Google Scholar 

  4. Kraulis, W.: Protracted shock in the treatment of schizophrenia and results of the therapy in Riga, Latvia. Am. J. Psychiat. (Suppl), 94:324, May 1938.

    Google Scholar 

  5. Lester, David: A study of prolonged coma following insulin shock. Am. J. Psychiat., 95:1083, March 1939.

    Google Scholar 

  6. Easton, Norman L.: A case of protracted hypoglycemia. Am. J. Psychiat., 94: 853, January 1938.

    Google Scholar 

  7. Kalichman, N.: The treatment and theory of prolonged insulin coma-with a case presentation.Psychiat. Quart., 22:213, April 1948.

    PubMed  CAS  Google Scholar 

  8. Goldfarb, Walter; Laughlin, J. M.; and Kiene, H. E.: Prolonged insulin shock. Am. J. Psychiat., 101:827, May 1944.

    Google Scholar 

  9. Wortis, Joseph; Bowman, Karl M.; Orenstein, Leo L.; and Rosenbaum, Irving: Further experiences at Bellevue Hospital with the hypoglycemic insulin treatment of schizophrenia. Am. J. Psychiat., 94:153, July 1937.

    Google Scholar 

  10. Cleckley, H., and Templeton, C. M.: Prolonged coma in insulin therapy of the psychoses. Am. J. Psychiat., 97:844, January 1941.

    Google Scholar 

  11. Freed Herbert, and Saxe, Earle: Prolonged non-hypoglycemic coma occurring during the course of insulin shock therapy. J. N. M. D., 90:216, August 1939.

    Google Scholar 

  12. Sikes, Z. S.: Novaldin and serum albumin in the treatment of irreversible insulin coma. Dis. Nerv. Sys., 13:20, January 1952.

    CAS  Google Scholar 

  13. Stark, William, and Barrera, S. Eugene: Use of potassium in protracted insulin coma. Arch. Neurol. and Psychiat., 62:280, September 1949.

    CAS  Google Scholar 

  14. Fineberg, S. K., and Altschul, Alexander: The encephalopathy of hyperinsulinism. Ann. Int. Med., 36:536, February 1952.

    PubMed  CAS  Google Scholar 

  15. Weil, Arthur; Liebert, Erich; and Heilbrune, Gert: Histopathologic changes in the brain in experimental hyperinsulism. Arch. Neurol. and Psychiat., 39:467, March 1938.

    Google Scholar 

  16. Lorentzen, K. A.: The central nervous system during insulin shock. Acta Psychiatrica et Neurologica. Suppl. 64, Copenhagen 1950.

  17. Levine, Burton: Clinico-pathological conference. J. Newark Beth Israel Hospital, 2:63, January 1951.

    Google Scholar 

  18. Fazekas, Joseph F.; Alman, R. W.; and Parrish, Alvin E.: Irreversible post hypoglycemic coma. Am. J. Med. Sci., 222:640, December 1951.

    Article  PubMed  CAS  Google Scholar 

  19. Halle, Louis, and Foss, T. F.: Neurological complications of insulin shock therapy with electro-encephalographic studies. Arch. Neurol. and Psychiat. 65:703, June 1951.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Veterans Administration Hospital, Lyons, N.J.

    Eugene Revitch M.D.

Authors
  1. Eugene Revitch M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Published with permission of the chief medical director, Department of Medicine and Surgery, Veterans Administration, who assumes no responsibility for the opinions expressed or conclusions drawn by the author.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Revitch, E. Observations on organic brain damage and clinical improvement following protracted insulin coma. Psych Quar 28, 72–92 (1954). https://doi.org/10.1007/BF01567038

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01567038

Keywords

Search

Navigation