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National
Hospital for Neurology and Neurosurgery, Queen Square, London WC1, UK
Correspondence to: Dr Howard Ring, Academic Department of Psychological Medicine, 3rd Floor, Alexandra Wing, Royal London Hospital, Whitechapel Road, London E1 1BB, UK.
Received 17 June 1997 and in revised form 10
October 1997;
Accepted 21 October 1997
OBJECTIVES
To examine prospectively the frequency
and nature of psychiatric symptoms seen in patients during the first
three months after temporal lobe surgery for chronic intractable
epilepsy and in addition to study the relation between presurgical
mental state, laterality of surgery, and postsurgical seizure and
psychiatric course.
METHODA consecutive series of 60 patients being
assessed for temporal lobe surgery for intractable epilepsy were
studied. They were interviewed before surgery and at six weeks and
again at three months after operation.
RESULTSAt 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 three 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 anxiety.
CONCLUSIONThe early months after surgery for
epilepsy are characterised 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.
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