Risk factors for early post-operative psychiatric symptoms in patients undergoing epilepsy surgery for temporal lobe epilepsy.
OBJECTIVE
De-novo psychiatric symptoms may develop within 3 months after a temporal lobectomy for epilepsy. The objective of this study was to identify presurgical risk factors for psychiatric symptoms.


METHODS
Twenty-seven patients who had a temporal lobectomy for epilepsy were included. Twenty-four had hippocampal sclerosis or gliosis, and three had cavernous haemagiomata. Twelve had operations on the left, and 15 on the right side. Twenty-four patients were rendered free of seizures (SZ) with loss of awareness, three had early post-operative convulsions, one continued to have habitual SZ.


RESULTS
Nine patients (33%) developed low mood, anxiety and emotional lability within 3 months after surgery. Patients with early post-operative psychiatric symptoms were younger (27.9/34.8 years, P = 0.01), and more anxious on the presurgical Hospital Anxiety and Depression Scale (12/8.44, P = 0.02) than patients without post-operative psychiatric symptoms. There was also an association between right temporal lobectomies and early post-surgical symptoms (P = 0.02 Fisher's exact test).


CONCLUSIONS
Potential risk factors were age, anxiety and operation on the right side. Larger studies are required to determine if these risk factors are independent.
Moss
K
K
Department of Neurology, Liverpool, UK.
O'Driscoll
K
K
Eldridge
P
P
Varma
T
T
Wieshmann
U C
UC
D000328:Adult; D000342:Affective Symptoms / Q000209:etiology*; D038481:Anterior Temporal Lobectomy / Q000523:psychology*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D018570:Risk Assessment; D016896:Treatment Outcome