Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Patel, Shivani; Clancy, Maurice; Barry, Helen; Quigley, N.; Clarke, Mary; Cannon, Mary; Delanty, Norman; Murphy, K. C.; Cotter, David

doi:10.1017/ipm.2020.114

Cited by 5 publications

(2 citation statements)

References 33 publications

(61 reference statements)

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“…A atividade epileptogênica generalizada poderia ter interferido em circuitos importantes relacionados ao controle do humor e do comportamento. Assim, foi sugerido que após neurocirurgias de grande porte, os pacientes estariam mais vulneráveis a desenvolver transtornos psiquiátricos 16 .…”

Section: Discussionunclassified

Transtornos psiquiátricos “de novo” na cirurgia de epilepsia

Zanarotti¹,

Winnubst²,

Centeno³

2021

Rev Neurocienc

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Introdução. A relação entre comorbidades psiquiátricas e as síndromes epilépticas, inclusive a psicose “de novo”, após cirurgias, são temas ainda elusivos e despertam grande interesse para estudos dentre psiquiatras, neurologistas, neurocirurgiões, profissionais da saúde em geral. Objetivos. investigar e caracterizar os transtornos psiquiátricos “de novo”, após a cirurgia de epilepsia, para melhor compreensão e avaliação dessas patologias. Método. Foi realizada uma revisão crítica da literatura, por meio de pesquisa bibliográfica realizada nas bases LILACS, Embase e Medline, entre 2010 e 2020. Resultados. Foram identificados 33 artigos. E selecionados 7 estudos que se enquadraram nos critérios de inclusão previamente estabelecidos nessa revisão. Conclusão. Os transtornos psicóticos parecem ser frequentes tanto no pré como no pós-operatório. São escassos os estudos clínicos sobre transtornos psiquiátricos “de novo”, após a cirurgia de epilepsia. Existem muitos relatos de uma remissão de transtornos psiquiátricos observados no pré-operatório. Entretanto, observa-se um acréscimo considerável de transtornos psiquiátricos “de novo” no pós-operatório, que somados aos pacientes com transtornos psiquiátricos sem remissão, pioram o resultado do desfecho psiquiátrico das cirurgias de epilepsia. Nesse sentido, a participação de um psiquiatra durante todo acompanhamento pré e pós-operatório mostra-se essencial na cirurgia de epilepsia.

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Section: Discussionunclassified

Transtornos psiquiátricos “de novo” na cirurgia de epilepsia

Zanarotti¹,

Winnubst²,

Centeno³

2021

Rev Neurocienc

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“…Diagnosing and treating depression and anxiety as part of the standard of care of PWE is fortunately more widely accepted today than in the past. 6 The presence of psychiatric co-morbidities should not prevent or limit access to epilepsy surgery 7 , 8 and furthermore the possibility of improvement in measures of depression and anxiety following epilepsy surgery 9 is a further incentive to offer our patients a surgical option when indicated. Every time we ask about psychiatric co-morbidities and their complications, we need to be ready to deal with the answers.…”

Section: Commentarymentioning

confidence: 99%

What Matters to You? Looking Beyond Seizure Freedom Following Epilepsy Surgery

Bermeo‐Ovalle¹

2021

Epilepsy Curr

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Objective: No validated tools exist to assess satisfaction with epilepsy surgery. We aimed to develop and validate a new measure of patient satisfaction with epilepsy surgery, the 19-item Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19). Methods: An initial 31-item measure was developed based on literature review, patient focus groups, thematic analysis, and Delphi panels. The questionnaire was administered twice, 4-6 weeks apart, to 229 adults (≥18 years old) who underwent epilepsy surgery ≥1 year earlier, at 3 centers in Canada and one in Sweden. Participants also completed 7 validated questionnaires to assess construct validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factorial structure of the questionnaire. Cronbach α and intraclass correlation coefficients (ICCs) assessed the internal consistency and test-retest reliability of the ESSQ-19. Spearman and polyserial correlations assessed construct validity. Results: Median age of participants and time since surgery were 42 years (interquartile range [IQR] = 32-54) and 5 years (IQR = 2-8.75), respectively. EFA and CFA yielded 18 items that segregated into 4 domains (mean score [SD]), namely, seizure control (76.4 [25]), psychosocial functioning (67.3 [26]), surgical complications (84 [22]), and recovery from surgery (73 [24]), one global satisfaction item, and a summary global score (74 [21]). The domain and summary scores demonstrated good to excellent internal reliability (Cronbach α range = .84-.95) and test-retest reliability (ICC range = .71-.85). Construct validity was supported by predicted correlations with other instruments. Significance: The ESSQ-19 is a new, valid, and reliable measure of patient satisfaction with epilepsy surgery that can be used in clinical and research settings.

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Delirium in neurosurgery: a systematic review and meta-analysis

et al. 2021

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Delirium is a frequent occurring complication in surgical patients. Nevertheless, a scientific work-up of the clinical relevance of delirium after intracranial surgery is lacking. We conducted a systematic review (CRD42020166656) to evaluate the current diagnostic work-up, incidence, risk factors and health outcomes of delirium in this population. Five databases (Embase, Medline, Web of Science, PsycINFO, Cochrane Central) were searched from inception through March 31st, 2021. Twenty-four studies (5589 patients) were included for qualitative analysis and twenty-one studies for quantitative analysis (5083 patients). Validated delirium screening tools were used in 70% of the studies, consisting of the Confusion Assessment Method (intensive care unit) (45%), Delirium Observation Screening Scale (5%), Intensive Care Delirium Screening Checklist (10%), Neelon and Champagne Confusion Scale (5%) and Nursing Delirium Screening Scale (5%). Incidence of post-operative delirium after intracranial surgery was 19%, ranging from 12 to 26% caused by variation in clinical features and delirium assessment methods. Meta-regression for age and gender did not show a correlation with delirium. We present an overview of risk factors and health outcomes associated with the onset of delirium. Our review highlights the need of future research on delirium in neurosurgery, which should focus on optimizing diagnosis and assessing prognostic significance and management.

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Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Cited by 5 publications

References 33 publications

Transtornos psiquiátricos “de novo” na cirurgia de epilepsia

Transtornos psiquiátricos “de novo” na cirurgia de epilepsia

What Matters to You? Looking Beyond Seizure Freedom Following Epilepsy Surgery

Delirium in neurosurgery: a systematic review and meta-analysis

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