Psychosis After Resection of Ganglioglioma or DNET: Evidence for an Association

Abstract

Summary:Purpose: David Taylor and Murray Falconer suggested that some patients may develop a psychotic illness after resection of a ganglioglioma that led to intractable seizures. They implied that the mechanism of this association remained unclear. This concept is currently not universally accepted (M. Trimble, personal communication).Methods: We studied six children or young adults from four centers who developed psychosis after resection of a ganglioglioma or dysembryoplastic neuroepithelioma (DNET).Results: All patients were operated on because of intractable epilepsy. The lesions involved mainly the temporal lobe. Patients had good outcomes for seizure control. In none of the six was potentially psychogenic medication used nor were the psychotic symptoms postictal in nature. The psychosis was schizophreniform with paranoid features and prominent depressiveThe suggestion of an increased occurrence of psychosis with prominent or paranoid depressive features or both after surgical treatment of temporal lobe epilepsy (TLE) due to ganglioglioma originated with David Taylor, Murray Falconer, and their group at the Maudsley Hospital (1-4). This concept has now been challenged by Trimble (personal communication), who is not convinced that the presence of a ganglioglioma predisposes to the development of psychosis after resection. In this analysis, the term schizophreniform is used to indicate a schizophrenia-like psychosis with paranoid and affective features and does not imply duration of symptoms or age of onset, as in the DSM-IV ( 5 ) definition of schizophrenia.Recent experience in the four participating centers suggests that psychosis may occur after resection of a

Cirurgia para epilepsia na infância: avaliação neuropsicológica e de qualidade de vida

“…Entretanto, ambos apresentaram piora comportamental importante. Andermann et al 27 sugerem que problemas psíquicos e comportamentais podem ocorrer em sujeitos submetidos à ressecção de tumores em lobo temporal e, por apresentarem bom resultado quanto ao controle das crises, aventam que o mecanismo de "normalização forçada" talvez seja o responsável por este fenômeno. As pacientes 1 e 9 apresentaram atraso de linguagem na avaliação pré-cirúrgica, ambas com epilepsia de lobo temporal esquerdo, coincidindo com os achados de Lendt et al 5 .…”

“…A não alteração significativa no QI pela maioria dos sujeitos após a cirurgia é congruente com outros estudos 6,27,28 .…”

Long-Term Psychiatric Outcomes After Epilepsy Surgery in Adults

“…Andermann et al reported six patients from four centers who experienced a de novo psychotic disorder and estimated a risk of 2.5 % for the development of de novo psychosis (1 in 39) in patients with this type of lesion who undergo an ATL [ 27 ].…”

Selection and Evaluation of Children for Epilepsy Surgery

“…Firlik et al [92]reported the concurrence of ganglioglioma and Rasmussen’s encephalitis in a 4-year-old boy who underwent a hemispherectomy with favorable results. Andermann et al [93]reported a small group of children from several different institutions that experienced a paranoid schizophrenic psychosis with depressive features after removal of gangliogliomas. This occurred in 1 of 39 resections and not in other types of lesional epilepsy surgery in the authors’ vast collective experience, indicating that this is a real, but unusual complication of resection.…”