Hostname: page-component-6bf8c574d5-8gtf8 Total loading time: 0 Render date: 2025-02-15T10:14:19.608Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric Assessment of Candidates for Epilepsy Surgery

Published online by Cambridge University Press:  02 December 2014

G. Savard  and
R. Manchanda
G. Savard
Affiliation:
Department of Neurology, and Department of Psychiatry, McGill University, and Montreal Neurological Hospital and Institute, QC., H3A2B4
R. Manchanda
Affiliation:
Department of Neurology, and Department of Psychiatry, McGill University, and Montreal Neurological Hospital and Institute, QC., H3A2B4
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Patients with medically intractable epilepsy often present with comorbid psychiatric diseases. When referred to a program for the surgical treatment of the epilepsies, these patients benefit from a pre-admission psychiatric assessment with a view to lessen the chances of a psychiatric crisis during the pre- and postoperative investigations. This article proposes a practical approach to the psychiatric assessment and monitoring of adult candidates to the surgery of epilepsy. It emphasizes, in agreement with a world literature review, that definitive psychiatric contraindications to this elective surgery are few, and that adverse long-term psychiatric outcomes are less frequent when good seizure outcome is achieved.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 27 , Issue S1: Canadian Temporal Lobe Epilepsy Surgery Workshop , May 2000 , pp. S44 - S49
Copyright
Copyright © The Canadian Journal of Neurological 2000

References

1. Manchanda, R, Schaefer, B, McLachlan, RS, et al. Psychiatric disorders in candidates for surgery for epilepsy. J Neurol Neurosurg Psychiatry 1996; 61(S1):82–89.Google Scholar
2. Blumer, D, Montouris, G, Hermann, B. Psychiatric morbidity in seizure patients on a neurodiagnostic monitoring unit. J Neuropsychiatry Clin Neurosci 1995;7(4):445–456.Google Scholar
3. Victoroff, J. DSM-III-R psychiatric diagnoses in candidates for epilepsy surgery: lifetime prevalences. Neuropsychiatry, Neuropsychol Behav Neurol 1994; 7:87–97.Google Scholar
4. Reutens, DC, Savard, G, Andermann, F, et al. Results of surgical treatment in temporal lobe epilepsy with chronic schizophrenia-like psychosis. Brain 1997; 120:1929–1936.Google Scholar
5. Savard, G, Andermann, LF, Reutens, DC, et al. Epilepsy, surgical treatment, and postoperative psychiatric complications: a reevaluation of the evidence. In: Trimble, MR and Schmitz, B, eds. Forced EEG normalization: a tribute to Hans Landolt. Bristol:Wrightson Biomedical Publishing, 1998;179–192.Google Scholar
6. American Psychiatric Association. Practice guideline for psychiatric evaluation of adults. Am J Psychiatry 1995; 152(Suppl):11:67–80.Google Scholar
7. Ovsiew, F. Bedside neuropsychiatry: eliciting the clinical phenomenon of neuropsychiatric illness. In: Yudofsky, SC and Hales, RE, eds. American Psychiatric Press Textbook of Neuropsychiatry. Washington, American Psychiatric Press, 1992; 89–125.Google Scholar
8. Mueller, J, Fogel, BS. Neuropsychiatric examination. In: Fogel, BS, Schiffer, RB, Rao, SM, eds. Neuropsychiatry. Baltimore, Williams&Wilkins, 1996;11–28.Google Scholar
9. Fenwick, PBC, Blumer, D, Caplan, R, et al. Presurgical psychiatric assessment. In: Engel, J Jr, ed. Surgical Treatment of the Epilepsies, 2nd Ed. New York: Raven Press, 273–290.Google Scholar
10. Krahn, LE, Rummans, TA, Peterson, GC. Psychiatric implications of surgical treatment of epilepsy. Mayo Clinic Proc 1996; 71(12):1201–1204.Google Scholar
11. Lancman, M. Psychosis and peri-ictal confusional states. Neurology, 1999;53(Suppl 2):S33–S38.Google Scholar
12. Ketter, TA, Post, RM, Theodore, WH. Positive and negative psychiatric effects of antiepileptic drugs in patients with seizure disorders. Neurology 1999; 53(Suppl 2):S53–S67.Google Scholar
13. Mah, L, Savard, G, Andermann, F, et al. Assessment of neuropsychiatric aspects of frontal lobe epilepsy. J Neuropsychiatry Clin Neurosci 1999; 11:S1, 132–133 (Abstract).Google Scholar
14. Rausch, R, Le, M-T, Langfitt, JT. Neuropsychological evaluation -adults. In: Engel, J Jr, Pedley, TA, eds. Epilepsy-a Comprehensive Textbook. Philadelphia, Lippincott-Raven, 1997;977–987.Google Scholar
15. American Psychiatric Association. Diagnostic and Stastistical Manual of Mental Disorders, 4th Ed. Washington: American Psychiatric Association Press, 1994.Google Scholar
16. Klüver, H, Bucy, PC. Psychic blindness and other symptoms following bilateral temporal lobectomy in rhesus monkeys. Am J Physiol 1937;119:352–353.Google Scholar
17. Trop, D, Olivier, A, Dubeau, F, et al. Seizure surgery-anesthetic, neurologic, neurosurgical, and neurobehavioral considerations. In: Albin, MS, ed. Textbook of Neuroanesthesia with Neurosurgical and Neuroscience Perspectives. New York: McGraw-Hill Companies, 1997, 643–696.Google Scholar
18. Alldredge, BK. Seizure risk associated with psychotropic drugs: clinical and pharmacokinetic considerations. Neurology 1999; 53(Suppl 2):S68–S75.Google Scholar
19. Ward, MM, Barbaro, NM, Laxer, KD, et al. Preoperative valproate administration does not increase blood loss during temporal lobectomy. Epilepsia 1996; 37(S1):98–101.Google Scholar
20. Anderson, GD, Lin, Y-X, Berge, C, et al. Absence of bleeding complications in patients undergoing cortical surgery while receiving valproate treatment. J Neurosurgery 1997; 87(2):252–256.Google Scholar
21. Stagno, SJ, Smith, ML. The presurgical workup: evaluation of psychiatric issues and informed consent. Luders, HO ed. New York: Raven Press, 1992, 453–460.Google Scholar
22a. Falconer, MA. Pathological substrates in temporal lobe epilepsy with psychoses. In: Laitinen, LV and Livingston, KE, eds. Surgical Approaches in Psychiatry. Baltimore: University Park Press, 1973, 121–124.Google Scholar
22b. Falconer, MA. Reversibility by temporal lobe resection of the behavioral abnormalities of temporal lobe epilepsy. N Engl J Med 1973; 289: 451–455.Google Scholar
23. Taylor, DC. Factors influencing the occurrence of schizophrenia-like psychosis in patients with temporal lobe epilepsy. Psychol Med 1975; 5:249–254.Google Scholar
24. Mace, CJ, Trimble, MR. Psychosis following temporal lobe surgery: a report of six cases. J Neurol Neurosurg Psychiatry 1991; 54:639–644.Google Scholar
25. Manchanda, R, Miller, H, McLachlan, RS. Post-ictal psychosis after right temporal lobectomy. J Neurol Neurosurg Psychiatry 1993; 56: 277–279.Google Scholar
26. Bruton, CJ. The Neuropathology of Temporal Lobe Epilepsy. Oxford: Oxford University Press, 1988; 158.Google Scholar
27. Andermann, F, Savard, G, Mencke, JH, et al. Psychosis after resection of ganglioglioma or DNET: evidence for an association. Epilepsia 1999;40(S1):83–87.Google Scholar
28. Naylor, AS, Rogvi-Hansen, BA, Kessing, L, et al. Psychiatric morbidity after surgery for epilepsy: short-term follow-up of patients undergoing amygdalohippocampectomy. J Neurol Neurosurg Psychiatry 1994;57(11): 1375- 1381.Google Scholar
29. Bladin, PF. Psychosocial difficulties and outcome after temporal lobectomy. Epilepsia 1992; 33(5):898–907.Google Scholar
30. Stevens, JR. Psychiatric consequences of temporal lobectomy for intractable seizures: a 20-30 year follow-up of 14 cases. Psychol Med 1990; 20: 529–545.Google Scholar
31. Leinonen, E, Tuunainen, A, Lepola, U. Postoperative psychoses in epileptic patients after temporal lobectomy. Acta Neurol Scand 1994; 90(6): 394–399.Google Scholar
32. Slater, E, Beard, AW, Glitheroe, E. The schizophrenia-like psychoses of epilepsy. Br J Psychiatry8 1963;109:95–150.Google Scholar
33. Toone, B. Psychoses of epilepsy. In: Reynolds, EH, Trimble, MR, eds. Edinburgh: Churchill Livingstone, 1981;113–137.Google Scholar
34. Landolt, H. Serial electroencephalographic investigations during psychotic episodes in epileptic patients and during schizophrenic attacks. In: De Haas, L, ed. Lectures on Epilepsy. New York: Elsevier, 1958, 91–133.Google Scholar
35. Robertson, MM. Forced normalization and the aetiology of depression in epilepsy. In: Trimble, MR and Schmitz, B, eds. Forced Normalization and Alternative Psychosis of Epilepsy. Bristol:Wrightson Biomedical Publishing, 1998, 143–167.Google Scholar
36. Pilcher, WH, Roberts, DW, Flanigin, HF, et al. Complications of epilepsy surgery. In: Surgical Treatment of the Epilepsies. 2nd ed. Engel, J Jr ed. New York: Raven Press, 1993, 565–581.Google Scholar
37. Engel, J Jr, Taylor, DC. Neurobiology of behavioral disorders. In: Engel, J Jr and Pedley, TA, eds. Epilepsy: A Comprehensive Textbook. Philadelphia: Lippincott-Raven Publishers, 1997, 2045–2052.Google Scholar