Psychiatric symptoms after temporal epilepsy surgery. A one-year follow-up study

Epilepsy Behav. 2017 May;70(Pt A):154-160. doi: 10.1016/j.yebeh.2017.02.029. Epub 2017 Apr 17.

Abstract

Psychiatric symptoms must be considered in patients with refractory temporal lobe epilepsy after epilepsy surgery. The main objectives of our study were to describe clinical and socio-demographical characteristics of a cohort of patients with pharmacoresistant temporal lobe epilepsy who underwent temporal lobe epilepsy surgery, and moreover, to evaluate possible risk factors for developing psychiatric symptoms. In order to achieve those goals, we conducted a prospective evaluation of psychopathology throughout the first year after surgery in a clinical sample of 72 patients, by means of three clinical rated measures; the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Brief Psychiatric Rating Scale (BPRS). The psychopathological evaluations were performed by an experienced psychiatrist. A presurgical evaluation was done by a multidisciplinary team (that includes neurologist, psychiatrist, neurosurgeon, neurophysiologist, radiologists, and nuclear medicine specialist) in all patients. The decision to proceed to surgery was taken after a surgical meeting of all members of the Multidisciplinary Epilepsy Unit team. The psychiatrist conducted two postoperative assessments at 6months and 12months after surgery. The main finding was that past history of mental illness (patients who were receiving psychiatric treatment prior to the baseline evaluation) was a risk factor for anxiety, depression, and psychosis after temporal lobe epilepsy surgery.

Keywords: Psychopathology; Refractory epilepsy; Risk factors; Temporal lobe epilepsy surgery.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Epilepsy, Temporal Lobe / psychology*
  • Epilepsy, Temporal Lobe / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / etiology
  • Mental Disorders / psychology*
  • Middle Aged
  • Postoperative Care / methods
  • Postoperative Care / psychology
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / psychology*
  • Preoperative Care / methods
  • Preoperative Care / psychology
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult