Postictal psychosis as a risk factor for mood disorders after temporal lobe surgery

This study investigated the psychiatric consequences of 38 consecutive patients who had surgery for intractable temporal lobe epilepsy with special attention to postoperative mood disorders. Aclose interrelation between preoperative postictal psychosis andpostoperative manic or depressive episodes was suggested. Left sidedlobectomy augmented this correlation. Because the first sign ofpostoperative manic and depressive episodes appeared within 1 month and2 months respectively, cautious psychiatric follow up for severalmonths after surgery proved to be crucial to prevent postoperativesuicides. Postoperative manic depressive episodes disappeared withinthe first 2 years after operation without exception, if treatedsuitably. This suggests that we do not have to preclude patients withpostictal psychosis as surgical candidates, but measures must be takento prevent postoperative depressions.