Psychiatric history does not predict seizure outcome following temporal lobectomy for mesial temporal sclerosis.
OBJECTIVE
A lifetime psychiatric history has been reported to be associated with poorer seizure outcome following temporal lobectomy for drug-resistant focal epilepsy, but it remains unclear whether this is confounded by the nature of the epileptogenic pathology. Here we examined this association in a pathologically homogeneous group of patients with mesial temporal sclerosis (MTS).


METHODS
The study population included 72 consecutive patients who underwent a temporal lobectomy for drug resistant temporal lobe epilepsy (TLE) and had histopathologically proven MTS. All patients were assessed preoperatively by a neuropsychiatrist. Chi-square analysis was undertaken to look for demographic, clinical, psychiatric, or neurologic factors associated with seizure outcome at 1 year. The relationship between having a psychiatric disorder and seizure outcome was examined by generating Kaplan-Meier curves and comparing between groups the log rank test as well as generating Cox regression models to estimate hazard ratios.


RESULTS
There were no significant associations between postsurgery seizure outcome and a current or lifetime history of any psychiatric disorder.


CONCLUSIONS
A history of psychiatric disorder, in particular depression and psychosis, is not associated with a poorer surgical outcome in patients with MTS. These findings have implications for the clinical management of patients under consideration for temporal lobectomy.
Melbourne Neuropsychiatry Centre, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia. sophia.adams@mh.org.au
Sophia J
SJ
Adams
Dennis
D
Velakoulis
Andrew H
AH
Kaye
Niall M
NM
Corcoran
Terence J
TJ
O'Brien
D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000379:methods*; D016009:Chi-Square Distribution; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D011237:Predictive Value of Tests; D012598:Sclerosis / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult