A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy
Abstract
PURPOSE: To identify the psychiatric and epilepsy variables predictive of postsurgical seizure outcome after anterotemporal lobectomy (ATL). METHODS: Retrospective study of 100 consecutive patients with temporal lobe epilepsy (TLE) who underwent ATL. The mean (+/- SD) follow-up period was 8.3 (+/- 3.1) years. Three types of surgical outcomes were examined at 2 years after surgery and at last contact: class IA (no disabling seizures no auras), class IA + IB (no disabling seizures), and class IA + IB + IC (no or rare disabling seizures in the first postsurgical year). Logistic regression analyses were performed separately for the three types of surgical outcomes. The epilepsy-related independent variables included age at onset, cause of TLE (mesial temporal sclerosis, lesional and cryptogenic TLE), extent of resection of mesial structures, neuropathologic abnormalities, having only complex partial seizures, and duration of the seizure disorder. The psychiatric independent variables included a postsurgical and presurgical lifetime history of mood, anxiety, attention deficit hyperactivity, and psychotic disorders. RESULTS: The absence of a psychiatric history was an independent predictor of all three types of surgical outcomes. In addition, a larger resection of mesial structures was a predictor for class IA outcome, and having only complex partial seizures (vs generalized tonic-clonic seizures) was a predictor for class IA + IB and IA + IB + IC. Having mesial temporal sclerosis (vs other causes of TLE) was a predictor for class IA + IB + IC as well. CONCLUSIONS: These data indicate that a lifetime psychiatric history may be predictive of a worse postsurgical seizure outcome after an anterotemporal lobectomy.
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Both population-based and experimental studies in human and animal models have demonstrated a robust relationship between seizures and psychiatric disorders.
“Both population-based and experimental studies in human and animal models have demonstrated a robust relationship between seizures and psychiatric disorders.”
From Cochrane systematic review and meta-analysis of the impact of psychological treatments for people with epilepsy on health-related quality of life (2018) · cites this paper as [14]
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Repeatedly stressed rats have enhanced vulnerability to amygdala kindling epileptogenesis
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- Authors
- Kanner, A. M., Byrne, R., Chicharro, A., Wuu, J., & Frey, M.
- Affiliations
- Rush University Medical Center (US)
- Venue
- Neurology
- Published
- 2009-03-03
- Volume
- 72
- Issue
- 9
- Pages
- 793-799
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2013841019
- Cited by
- 275
- References
- 17
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 10 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 34 · 2019: 17 · 2018: 16 · 2017: 18 · 2016: 17 · 2015: 25 · 2014: 22 · 2013: 20 · 2012: 25
- FWCI
- 12.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- temporal lobe epilepsy, seizure outcome, psychiatric history, mood disorders, anxiety disorders, attention deficit hyperactivity disorder, psychosis, hippocampal sclerosis, extent of resection, complex partial seizures, predictors of surgical outcome
- MeSH terms
- Adult, Mental Disorders, Epilepsy, Temporal Lobe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications, Predictive Value of Tests, Retrospective Studies, Seizures, Time Factors, Treatment Outcome, Anterior Temporal Lobectomy, Young Adult
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