Risk factors for early post-operative psychiatric symptoms in patients undergoing epilepsy surgery for temporal lobe epilepsy

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Abstract:

Moss K, O’Driscoll K, Eldridge P, Varma T, Wieshmann UC. Risk factors for early post-operative psychiatric symptoms in patients undergoing epilepsy surgery for temporal lobe epilepsy.

Acta Neurol Scand 2009: 120: 176–181.

© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective – 

De-novo psychiatric symptoms may develop within 3 months after a temporal lobectomy for epilepsy. The objective of this study was to identify presurgical risk factors for psychiatric symptoms. Methods – 

Twenty-seven patients who had a temporal lobectomy for epilepsy were included. Twenty-four had hippocampal sclerosis or gliosis, and three had cavernous haemagiomata. Twelve had operations on the left, and 15 on the right side. Twenty-four patients were rendered free of seizures (SZ) with loss of awareness, three had early post-operative convulsions, one continued to have habitual SZ. Results – 

Nine patients (33%) developed low mood, anxiety and emotional lability within 3 months after surgery. Patients with early post-operative psychiatric symptoms were younger (27.9/34.8 years, P = 0.01), and more anxious on the presurgical Hospital Anxiety and Depression Scale (12/8.44, P = 0.02) than patients without post-operative psychiatric symptoms. There was also an association between right temporal lobectomies and early post-surgical symptoms (P = 0.02 Fisher’s exact test). Conclusion – 

Potential risk factors were age, anxiety and operation on the right side. Larger studies are required to determine if these risk factors are independent.

Keywords: epilepsy; post-operative depression and anxiety; surgery; temporal lobectomy

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0404.2008.01149.x

Affiliations: 1: 1Neurology and 2: 2Neurosurgery, Liverpool, UK

Publication date: September 1, 2009

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