Pre-surgical predictors for psychiatric disorders following epilepsy surgery in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis

Pre-surgical predictors for psychiatric disorders following epilepsy surgery in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis

Author Araujo Filho, Gerardo Maria de Autor UNIFESP Google Scholar
Mazetto, Lenon Autor UNIFESP Google Scholar
Gomes, Francinaldo Lobato Autor UNIFESP Google Scholar
Marinho, Murilo Martinez Autor UNIFESP Google Scholar
Tavares, Igor Melo Autor UNIFESP Google Scholar
Sales Ferreira Caboclo, Luis Otavio Autor UNIFESP Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Targas Yacubian, Elza Marcia Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Psychiatric outcomes of patients submitted to epilepsy surgery have gained particular interest given the high prevalence of pre-surgical psychiatric disorders (PD) in this population. the present study aimed to verify the possible pre-surgical predictors for psychiatric disorders following epilepsy surgery in a homogeneous series of patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). Data from 115 TLE-MTS patients (65 females; 56.5%) who underwent cortico-amygdalohippocampectomy were included. Pre- and post-surgical psychiatric evaluations were performed using DSM-IV criteria. Pre-surgical PD - particularly mood, anxiety and psychotic disorders - were diagnosed in 47 patients (40.8%). Twenty-seven patients (54% of those with pre-surgical PD) demonstrated a remission of psychiatric symptoms on post-surgical psychiatric evaluation. Eleven patients (9.6%) developed de novo PD. the presence of pre-surgical depression (OR= 3.32; p=0.008), pre-surgical interictal psychosis (OR = 4.39; p=0.009) and epileptiform discharges contralateral to the epileptogenic zone (OR = 2.73; p = 0.01) were risk factors associated with post-surgical PD. Although epilepsy surgery is considered to be the best treatment option for patients with refractory TLE-MTS, the relatively high psychiatric comorbidities observed in surgical candidates and their possible negative impact on post-surgical outcomes require a careful pre-surgical evaluation of clinical, sociodemographic and psychiatric factors. (C) 2012 Elsevier B.V. All rights reserved.
Keywords Temporal lobe epilepsy
Mesial temporal sclerosis
Epilepsy surgery
Psychiatric disorders
Psychiatric 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 2012-11-01
Published in Epilepsy Research. Amsterdam: Elsevier B.V., v. 102, n. 1-2, p. 86-93, 2012.
ISSN 0920-1211 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 86-93
Origin http://dx.doi.org/10.1016/j.eplepsyres.2012.05.005
Access rights Closed access
Type Article
Web of Science ID WOS:000311529400010
URI http://repositorio.unifesp.br/handle/11600/35460

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