Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis

Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis

Author Araujo Filho, Gerardo Maria de Autor UNIFESP Google Scholar
Gomes, Francinaldo Lobato Autor UNIFESP Google Scholar
Mazetto, Lenon Autor UNIFESP Google Scholar
Marinho, Murilo Martinez Autor UNIFESP Google Scholar
Tavares, Igor Melo Autor UNIFESP Google Scholar
Caboclo, Luís Otávio Sales Ferreira Autor UNIFESP Google Scholar
Yacubian, Elza Márcia Targas Autor UNIFESP Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: the association between pre-surgical psychiatric disorders (PDs) and worse seizure outcome in patients with refractory epilepsy submitted to surgery has been increasingly recognized in the literature. the present study aimed to verify the impact of pre- and post-surgical PD on seizure outcome in a series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS).Method: Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohip-pocampectomy (CAH) were analyzed. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV and ILAE criteria. the outcome subcategory Engel IA was considered as corresponding to a favorable prognosis. A multivariate logistic regression model was applied to identify possible risk factors associated with a worse seizure outcome.Results: Pre-surgical PDs, particularly major depressive disorder (MDD), anxiety and psychotic disorders, were common, being found in 47 patients (40.8%). Fifty-six patients (48.7%) were classified as having achieved an Engel IA one year after CAH. According to the logistic regression model, the presence of pre-surgical MDD (OR = 5.23: p = 0.003) appeared as the most important risk factor associated with a non-favorable seizure outcome.Conclusion: Although epilepsy surgery may be the best treatment option for patients with refractory TLE-MTS, our findings emphasize the importance of performing a detailed psychiatric examination as part of the pre-surgical evaluation protocol. (C) 2012 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
Keywords Temporal lobe epilepsy
Mesial temporal sclerosis
Epilepsy surgery
Psychiatric disorders
Seizure outcome
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Date 2012-10-01
Published in Seizure-european Journal of Epilepsy. London: W B Saunders Co Ltd, v. 21, n. 8, p. 619-623, 2012.
ISSN 1059-1311 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co Ltd
Extent 619-623
Origin http://dx.doi.org/10.1016/j.seizure.2012.07.002
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000308628500013
URI http://repositorio.unifesp.br/handle/11600/35304

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