Are psychiatric disorders exclusion criteria for video-EEG monitoring and epilepsy surgery in patients with mesial temporal sclerosis?

Are psychiatric disorders exclusion criteria for video-EEG monitoring and epilepsy surgery in patients with mesial temporal sclerosis?

Author Conceicao, Priscila Oliveira da Autor UNIFESP Google Scholar
Nascimento, Pedro Paulo Autor UNIFESP Google Scholar
Mazetto, Lenon Autor UNIFESP Google Scholar
Alonso, Neide Barreira Autor UNIFESP Google Scholar
Targas Yacubian, Elza Marcia Autor UNIFESP Google Scholar
Araujo Filho, Gerardo Maria de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Epilepsy surgery (ES) is a treatment option for patients with refractory temporal lobe epilepsy (TLE). However, psychiatric disorders (PDs) have been a contraindication for presurgical evaluation in many epilepsy centers. the aim of this study was to evaluate the safety of video-EEG (VEEG) and surgical outcome in patients with refractory TLE and mesial temporal sclerosis (TLE-MTS) associated with PDs. We retrospectively analyzed the clinical, sociodemographic, and VEEG data and surgery outcome of patients with refractory TLE-MTS who underwent ES over the period of 2002 to 2011 and compared data between those with and without PDs. Psychiatric evaluation was performed through DSM-IV and ILAE criteria. Safety during presurgical evaluation was analyzed by the rate of adverse events (AEs). Patients' quality of life (QOL) was measured through ESI-55 and the surgical outcome through Engel's classification. Data from 145 patients were included. the mean VEEG length (93 h) was not affected by PDs. Among patients with PDs, 4.91% (3/61) had AEs, and 13.11% (8/61) had psychogenic nonepileptic seizures (PNESs). Among patients without PDs, 4.76% (4/84) had AEs, and 5.95% (5/84) had PNESs. in the first two follow-up years, of the 94 patients who underwent ES, 65.85% (27/41) with PDs and 67.92% (36/53) without PDs became free of disabling seizures (Engel I). No significant differences were observed in the patients' QOL between both groups after surgery. the rate of AEs and seizure outcome did not differ significantly between both groups, reinforcing the idea that PDs should not be absolute exclusion criteria for VEEG monitoring and epilepsy surgery among patients with TLE-MTS. (C) 2013 Elsevier Inc. All rights reserved.
Keywords Mesial temporal sclerosis
Psychiatric disorders
Video-EEG monitoring
Surgical 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 2013-05-01
Published in Epilepsy & Behavior. San Diego: Academic Press Inc Elsevier Science, v. 27, n. 2, p. 310-314, 2013.
ISSN 1525-5050 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 310-314
Access rights Closed access
Type Article
Web of Science ID WOS:000317723900007

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