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Psychiatric symptom changes after corticoamygdalohippocampectomy in patients with medial temporal lobe epilepsy through Symptom Checklist 90 Revised
Authors:Zhang Guangming MD  Zhou Wenjing MD  Chen Guoqiang MD  Zhu Yan MD  Zhang Fuquan MD  Zuo Huancong MD
Affiliation:aDepartment of Neurosurgery, Institute of Neurological Disorder, Yuquan Hospital, School of Medicine Tsinghua University, Beijing 100049, China;bState Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China;cDepartment of Psychology, Institute of Neurological Disorder, Yuquan Hospital, School of Medicine Tsinghua University, Beijing 100049, China
Abstract:

Background

Corticoamygdalohippocampectomy (anterior temporal lobe resection plus amygdalohippocampectomy) is common in epilepsy surgery. Pre- and postoperative psychiatric disorders occurred sometimes in patients with refractory medial TLE. We want to know if CAH has an affirmative effect on the psychiatric symptom of patients with medial TLE through a quantitative method.

Methods

Sixty-two patients with medial TLE who had CAH accomplished SCL-90-R questionnaires thrice (presurgical and postsurgical 1 and 2 years). Average GSI scores in SCL-90-R were calculated and statistically analyzed.

Results

There was no statistical difference in the presurgical average GSI scores between Engel I and Engel II to IV subgroup. Postoperative 1 and 2 years' average GSI scores of Engel II to IV subgroup were both statistically higher than those of Engel I subgroup. There were no statistical differences between other subgroups in different time. Postsurgical 1 and 2 years' average GSI scores of the whole group and Engel I subgroup were statistically lower than those of presurgery. Postoperative 2 years' average GSI scores of the whole group and Engel I subgroup were statistically lower than those of postsurgical 1 year. For Engel II to IV subgroup, there were no statistical differences among the average GSI scores in different time.

Conclusion

Corticoamygdalohippocampectomy could improve the psychiatric symptoms of patients with TLE as assessed by the SCL-90-R. This improvement was related to the therapeutic effect and was not related to sex, lateralization, and MRI abnormality.
Keywords:Abbreviations: AED, antiepileptic drug   AMRI, abnormal MRI   CAH, corticoamygdalohippocampectomy   GSI, global severity index   MRI, magnetic resonance imaging   NMRI, normal MRI   SCL-90-R, Symptom Checklist 90 Revised   TLE, temporal lobe epilepsy
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