A PROSPECTIVE-STUDY OF THE EARLY POSTSURGICAL PSYCHIATRIC ASSOCIATIONS OF EPILEPSY SURGERY

Objectives-To examine prospectively the frequency and nature of psychi atric symptoms seen in patients during the first three months after te mporal lobe surgery for chronic intractable epilepsy and in addition t o study the relation between presurgical mental state, laterality of s urgery, and postsurgical seizure and psychiatric course. Method-A cons ecutive series of 60 patients being assessed for temporal lobe surgery for intractable epilepsy were studied. They were interviewed before s urgery and at six weeks and again at three months after operation. Res ults-At six weeks after surgery half of those with no psychopathology preoperatively had developed symptoms of anxiety or depression and 45% of all patients were noted to have increased emotional lability. By t hree months after surgery emotional lability and anxiety symptoms had diminished whereas depressive states tended to persist. Patients with a left hemispheric focus were more likely to experience persisting anx iety. Conclusion-The early months after surgery for epilepsy are chara cterised by the relatively common presence of psychiatric symptoms. It is proposed that presurgical and early postsurgical neuropsychiatric involvement in programmes of surgery for epilepsy will help to improve the quality of the treatment package offered to patients.