The Psychiatric Quarterly

, Volume 28, Issue 1–4, pp 72–92

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

  • Eugene Revitch
Article

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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 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. 2.
    Wells, F. L., and Ruesch, T.: Mental Examiner's Handbook. Pp. 48–52. Psychological Corporation. New York. 1945.Google Scholar
  3. 3.
    Goldman, Douglas: Prolonged coma after insulin hypoglycemia, clinical features and treatment. J. N. M. D., 92:157, August 1940.CrossRefGoogle Scholar
  4. 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. 5.
    Lester, David: A study of prolonged coma following insulin shock. Am. J. Psychiat., 95:1083, March 1939.Google Scholar
  6. 6.
    Easton, Norman L.: A case of protracted hypoglycemia. Am. J. Psychiat., 94: 853, January 1938.Google Scholar
  7. 7.
    Kalichman, N.: The treatment and theory of prolonged insulin coma-with a case presentation.Psychiat. Quart., 22:213, April 1948.PubMedGoogle Scholar
  8. 8.
    Goldfarb, Walter; Laughlin, J. M.; and Kiene, H. E.: Prolonged insulin shock. Am. J. Psychiat., 101:827, May 1944.Google Scholar
  9. 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. 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. 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. 12.
    Sikes, Z. S.: Novaldin and serum albumin in the treatment of irreversible insulin coma. Dis. Nerv. Sys., 13:20, January 1952.Google Scholar
  13. 13.
    Stark, William, and Barrera, S. Eugene: Use of potassium in protracted insulin coma. Arch. Neurol. and Psychiat., 62:280, September 1949.Google Scholar
  14. 14.
    Fineberg, S. K., and Altschul, Alexander: The encephalopathy of hyperinsulinism. Ann. Int. Med., 36:536, February 1952.PubMedGoogle Scholar
  15. 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. 16.
    Lorentzen, K. A.: The central nervous system during insulin shock. Acta Psychiatrica et Neurologica. Suppl. 64, Copenhagen 1950.Google Scholar
  17. 17.
    Levine, Burton: Clinico-pathological conference. J. Newark Beth Israel Hospital, 2:63, January 1951.Google Scholar
  18. 18.
    Fazekas, Joseph F.; Alman, R. W.; and Parrish, Alvin E.: Irreversible post hypoglycemic coma. Am. J. Med. Sci., 222:640, December 1951.PubMedCrossRefGoogle Scholar
  19. 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.Google Scholar

Copyright information

© The Psychiatric Quarterly 1954

Authors and Affiliations

  • Eugene Revitch
    • 1
  1. 1.Veterans Administration HospitalLyons

Personalised recommendations