A prospective study of the early postsurgical psychiatric associations of epilepsy surgery

OBJECTIVES— To examine prospectively the frequencyand nature of psychiatric symptoms seen in patients during the firstthree months after temporal lobe surgery for chronic intractableepilepsy and in addition to study the relation between presurgicalmental state, laterality of surgery, and postsurgical seizure andpsychiatric course.
METHOD—A consecutive series of 60 patients beingassessed for temporal lobe surgery for intractable epilepsy werestudied. They were interviewed before surgery and at six weeks andagain at three months after operation.
RESULTS—At six weeks after surgery half of thosewith no psychopathology preoperatively had developed symptoms ofanxiety or depression and 45% of all patients were noted to haveincreased emotional lability. By three months after surgery emotionallability and anxiety symptoms had diminished whereas depressive statestended to persist. Patients with a left hemispheric focus were morelikely to experience persisting anxiety.
CONCLUSION—The early months after surgery forepilepsy are characterised by the relatively common presence ofpsychiatric symptoms. It is proposed that presurgical and earlypostsurgical neuropsychiatric involvement in programmes of surgery forepilepsy will help to improve the quality of the treatment packageoffered to patients.