Do psychiatric comorbidities predict postoperative seizure outcome in temporal lobe epilepsy surgery?

Anxiety disorders in people with epilepsy

“…The presence of anxiety predicts a worse seizure outcome after epilepsy surgery (Guarnieri et al, 2009). Epilepsy surgery, vice versa, may improve preexisting anxiety symptoms especially when seizure freedom could be achieved (Meldolesi et al, 2007, Devinsky et al, 2005, Cleary et al, 2013.…”

Pre-surgical mood disorders associated to worse post-surgical seizure outcome in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis

“…Surgery became an important treatment option for patients with refractory TLE-MTS and ATL has appeared as a safe and efficient surgical procedure, [1][2][3][4][5] althoughsome authors have highlighted the relative high risk of the appearance of PD in patients submitted to surgical procedure, while other studies do not support such hypothesis. 16,[21][22][23][24] Some recent studies consider pre-surgical PD as predictors of seizure outcome after surgery.…”

“…After opening the temporal horn, the mesial temporal structures (hippocampus, amygdala and parahyppocampal gyrus) were also resected "en block". 1,2,5 The most recent Engel's classification was utilized to measure the patients' seizure outcome, 18 and only the subcategory Engel IA (completely seizure-free since surgery) was considered as a favorable prognosis. Initial precipitant injury (IPI) was defined as the occurrence of severe cerebral events in the first year of life before the appearance of epilepsy that required medical intervention and/or hospitalization.…”

“…[1][2][3][4][5] Refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) is a condition that compromises the main structures of the limbic system,being also one of the most common surgically remediable epileptic syndromes. [1][2][3][4][5] Studies have observed a comorbid psychiatric prevalence rate of 20-40% in TLE-MTS, rising to 70% in patients with refractory forms of epilepsy. [6][7][8][9][10][11] Mood disorders are the most common (24-74%), followed by anxiety (10-25%), psychotic (2-9%) and personality disorders (1-2%).…”

Epilepsikirurgi - utredning og pasientseleksjon

“…Psykiatrisk komorbiditet, inkludert angst, depresjon, atferdsforstyrrelser og psykoser, ble tidligere ansett som en relativ kontraindikasjon til kirurgi. I de senere år har man imidlertid endret holdning, idet man har sett at psykiatriske symptomer som regel ikke blir verre etter inngrepene, i mange tilfeller tvert imot (14,15). Pasienter med betydelig psykiatrisk komorbiditet har allikevel mindre sjanse for å bli anfallsfrie etter resektiv kirurgi enn pasienter uten slike problemer (14,15).…”