Surgical treatment of temporal lobe epilepsy with interictal psychosis: results of six cases.
We describe the postsurgical outcome of six patients with medically intractable temporal lobe epilepsy and interictal psychosis who underwent temporal lobe resection. All patients were submitted to a comprehensive presurgical investigation, including prolonged video-EEG monitoring. Despite their psychotic disorders, all patients were able to provide informed consent and we were able to complete the investigation of all cases. Surgical complications occurred in two cases. Seizure outcome was Engel class I (free from incapacitating seizures) in all except one patient. There was no worsening of their psychoses. Until now, there has been relative improvement in the mental conditions of five patients. Although psychosis has been considered by some authors as a contraindication to epilepsy surgery, with appropriate psychiatric intervention, patients with refractory epilepsy and chronic interictal psychosis may be submitted to prolonged presurgical investigation and undergo surgery successfully.
Marchetti
Renato L
RL
Institute and Department of Psychiatry, University of São Paulo, Rua Campevas 447, Perizes, São Paulo, SP, Brazil. rlmarche@dialdata.com.br
Fiore
Lia A
LA
Valente
Kette D
KD
Gronich
Gary
G
Nogueira
Adriano B
AB
Tzu
Wen H
WH
D000328:Adult; D038481:Anterior Temporal Lobectomy; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002908:Chronic Disease; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D014150:Antipsychotic Agents