title: Predicting and preventing psychopathology following temporal lobe epilepsy surgery.
abstract: Less than 3% of temporal lobe epilepsy (TLE) surgical outcome studies have investigated the psychiatric sequelae and morbidity associated with surgery. This is disproportionate to the extent of the problem. Variable prevalence rates have been reported for post-surgical depression, anxiety, and interictal psychosis. Until recently, very few studies distinguished de novo postoperative presentations from pre-existing conditions, making it difficult to accurately assess the impact of TLE surgery on psychiatric morbidity. Predictors of de novo postoperative presentations have proved elusive. This current review summarizes the findings from a systematic literature review of the psychiatric morbidity associated with TLE surgery including newly published follow-up data from our own series of 280 surgical patients. A framework for future research, possible pathophysiological mechanisms, and translational models are also discussed.
authors.affiliation: Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London WC1N 3BG, UK. r.cleary@ucl.ac.uk
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Cleary
authors.forename: Sallie A
authors.initials: SA
authors.lastname: Baxendale
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Thompson
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Foong
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D011237:Predictive Value of Tests