Complete remission of epileptic psychosis after temporal lobectomy: case report.
We report a case of a female patient with refractory complex partial seizures since 15 years of age, recurrent postictal psychotic episodes since 35 which evolved to a chronic refractory interictal psychosis and MRI with right mesial temporal sclerosis (MTS). After a comprehensive investigation (video-EEG intensive monitoring, interictal and ictal SPECT, and a neuropsychological evaluation including WADA test) she was submitted to a right temporal lobectomy. Since then, she has been seizure-free with remission of psychosis, although with some persistence of personality traits (hiperreligiosity, viscosity) which had been present before surgery. This case supports the idea that temporal lobectomy can be a safe and effective therapeutic measure for patients with MTS, refractory epilepsy and recurrent postictal epileptic psychosis or interictal epileptic psychosis with postictal exacerbation.
Marchetti
R L
RL
Psychiatry Institute, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil. rlmarche@dialdata.com.br
Tavares
A G
AG
Gronich
G
G
Fiore
L A
LA
Ferraz
R B
RB
D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011618:Psychotic Disorders / Q000209:etiology / Q000601:surgery*; D013702:Temporal Lobe / Q000601:surgery*