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Title: Pre-surgical predictors for psychiatric disorders following epilepsy surgery in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis
Authors: Araujo Filho, Gerardo Maria de [UNIFESP]
Mazetto, Lenon [UNIFESP]
Gomes, Francinaldo Lobato [UNIFESP]
Marinho, Murilo Martinez [UNIFESP]
Tavares, Igor Melo [UNIFESP]
Sales Ferreira Caboclo, Luis Otavio [UNIFESP]
Centeno, Ricardo Silva [UNIFESP]
Targas Yacubian, Elza Marcia [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Keywords: Temporal lobe epilepsy
Mesial temporal sclerosis
Epilepsy surgery
Psychiatric disorders
Psychiatric outcome
Issue Date: 1-Nov-2012
Publisher: Elsevier B.V.
Citation: Epilepsy Research. Amsterdam: Elsevier B.V., v. 102, n. 1-2, p. 86-93, 2012.
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.
ISSN: 0920-1211
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