A prospective study of the early postsurgical psychiatric associations of epilepsy surgery.
OBJECTIVE
To examine prospectively the frequency and nature of psychiatric symptoms seen in patients during the first three months after temporal lobe surgery for chronic intractable epilepsy and in addition to study the relation between presurgical mental state, laterality of surgery, and postsurgical seizure and psychiatric course.


METHODS
A consecutive series of 60 patients being assessed for temporal lobe surgery for intractable epilepsy were studied. They were interviewed before surgery and at six weeks and again at three months after operation.


RESULTS
At six weeks after surgery half of those with no psychopathology preoperatively had developed symptoms of anxiety or depression and 45% of all patients were noted to have increased emotional lability. By three months after surgery emotional lability and anxiety symptoms had diminished whereas depressive states tended to persist. Patients with a left hemispheric focus were more likely to experience persisting anxiety.


CONCLUSIONS
The early months after surgery for epilepsy are characterised by the relatively common presence of psychiatric symptoms. It is proposed that presurgical and early postsurgical neuropsychiatric involvement in programmes of surgery for epilepsy will help to improve the quality of the treatment package offered to patients.
Ring
H A
HA
National Hospital for Neurology and Neurosurgery, London, UK.
Moriarty
J
J
Trimble
M R
MR
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000503:physiopathology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000503:physiopathology; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology; D004292:Dominance, Cerebral / Q000502:physiology; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000503:physiopathology; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D016896:Treatment Outcome