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Psychiatric history does not predict seizure outcome following temporal lobectomy for mesial temporal sclerosis
Author(s) -
Adams Sophia J.,
Velakoulis Dennis,
Kaye Andrew H.,
Corcoran Niall M.,
O’Brien Terence J.
Publication year - 2012
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2012.03569.x
Subject(s) - anterior temporal lobectomy , temporal lobe , epilepsy , psychosis , psychiatry , population , hippocampal sclerosis , proportional hazards model , psychology , psychiatric history , epilepsy surgery , depression (economics) , medicine , surgery , economics , macroeconomics , environmental health
Summary Purpose: A lifetime psychiatric history has been reported to be associated with poorer seizure outcome following temporal lobectomy for drug‐resistant focal epilepsy, but it remains unclear whether this is confounded by the nature of the epileptogenic pathology. Here we examined this association in a pathologically homogeneous group of patients with mesial temporal sclerosis (MTS). Methods: The study population included 72 consecutive patients who underwent a temporal lobectomy for drug resistant temporal lobe epilepsy (TLE) and had histopathologically proven MTS. All patients were assessed preoperatively by a neuropsychiatrist. Chi‐square analysis was undertaken to look for demographic, clinical, psychiatric, or neurologic factors associated with seizure outcome at 1 year. The relationship between having a psychiatric disorder and seizure outcome was examined by generating Kaplan‐Meier curves and comparing between groups the log rank test as well as generating Cox regression models to estimate hazard ratios. Key Findings: There were no significant associations between postsurgery seizure outcome and a current or lifetime history of any psychiatric disorder. Significance: A history of psychiatric disorder, in particular depression and psychosis, is not associated with a poorer surgical outcome in patients with MTS. These findings have implications for the clinical management of patients under consideration for temporal lobectomy.