Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2000 Jan;68(1):53–58. doi: 10.1136/jnnp.68.1.53

Psychiatric aspects of temporal lobe epilepsy before and after anterior temporal lobectomy

G Glosser 1, A Zwil 1, D Glosser 1, M O'Connor 1, M Sperling 1
PMCID: PMC1760635  PMID: 10601402

Abstract

OBJECTIVES—Psychopathology has been reported to be prevalent both before and after surgical treatment for medically intractable temporal lobe epilepsy. Individual patients were evaluated prospectively to assess the effect of anterior temporal lobectomy (ATL) on prevalence and severity of psychiatric disease.
METHODS—Psychiatric status was assessed in a consecutive series of epilepsy patients before and 6 months after ATL using a structured psychiatric interview, psychiatric rating scales, and self report mood measures.
RESULTS—A DSM-III-R axis I diagnosis was present in 65% of patients before and after surgery. The most common diagnoses were depression, anxiety, and organic mood/personality disorders. There was a trend for major psychiatric diagnoses to be more common in patients with right compared to left temporal lobe seizure focus, both before and after surgery. The apparent stability in the overall rate of psychiatric dysfunction concealed onset of new psychiatric problems in 31% of patients in the months shortly after surgery, and resolution of psychiatric diagnoses in 15% of patients. In the group as a whole, the severity of psychiatric symptoms was lower at 6 months postsurgery than before temporal lobectomy.
CONCLUSIONS—The overall prevalence of psychiatric dysfunction was comparably high before and after ATL, but individual changes in psychiatric status and changes in severity of symptoms occurred in many patients in the 6 months after surgery.



Full Text

The Full Text of this article is available as a PDF (86.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altshuler L. L., Devinsky O., Post R. M., Theodore W. Depression, anxiety, and temporal lobe epilepsy. Laterality of focus and symptoms. Arch Neurol. 1990 Mar;47(3):284–288. doi: 10.1001/archneur.1990.00530030050016. [DOI] [PubMed] [Google Scholar]
  2. BECK A. T., WARD C. H., MENDELSON M., MOCK J., ERBAUGH J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004. [DOI] [PubMed] [Google Scholar]
  3. Bear D. M., Fedio P. Quantitative analysis of interictal behavior in temporal lobe epilepsy. Arch Neurol. 1977 Aug;34(8):454–467. doi: 10.1001/archneur.1977.00500200014003. [DOI] [PubMed] [Google Scholar]
  4. Bladin P. F. Psychosocial difficulties and outcome after temporal lobectomy. Epilepsia. 1992 Sep-Oct;33(5):898–907. doi: 10.1111/j.1528-1157.1992.tb02198.x. [DOI] [PubMed] [Google Scholar]
  5. Blumer D., Montouris G., Hermann B. Psychiatric morbidity in seizure patients on a neurodiagnostic monitoring unit. J Neuropsychiatry Clin Neurosci. 1995 Fall;7(4):445–456. doi: 10.1176/jnp.7.4.445. [DOI] [PubMed] [Google Scholar]
  6. Blumer D., Wakhlu S., Davies K., Hermann B. Psychiatric outcome of temporal lobectomy for epilepsy: incidence and treatment of psychiatric complications. Epilepsia. 1998 May;39(5):478–486. doi: 10.1111/j.1528-1157.1998.tb01409.x. [DOI] [PubMed] [Google Scholar]
  7. Chovaz C. J., McLachlan R. S., Derry P. A., Cummings A. L. Psychosocial function following temporal lobectomy: influence of seizure control and learned helplessness. Seizure. 1994 Sep;3(3):171–176. doi: 10.1016/s1059-1311(05)80185-2. [DOI] [PubMed] [Google Scholar]
  8. Flor-Henry P. Psychosis and temporal lobe epilepsy. A controlled investigation. Epilepsia. 1969 Sep;10(3):363–395. doi: 10.1111/j.1528-1157.1969.tb03853.x. [DOI] [PubMed] [Google Scholar]
  9. Hermann B. P., Wyler A. R., Ackerman B., Rosenthal T. Short-term psychological outcome of anterior temporal lobectomy. J Neurosurg. 1989 Sep;71(3):327–334. doi: 10.3171/jns.1989.71.3.0327. [DOI] [PubMed] [Google Scholar]
  10. Hermann B. P., Wyler A. R., Somes G. Preoperative psychological adjustment and surgical outcome are determinants of psychosocial status after anterior temporal lobectomy. J Neurol Neurosurg Psychiatry. 1992 Jun;55(6):491–496. doi: 10.1136/jnnp.55.6.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Jensen I., Larsen J. K. Mental aspects of temporal lobe epilepsy. Follow-up of 74 patients after resection of a temporal lobe. J Neurol Neurosurg Psychiatry. 1979 Mar;42(3):256–265. doi: 10.1136/jnnp.42.3.256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Koch-Weser M., Garron D. C., Gilley D. W., Bergen D., Bleck T. P., Morrell F., Ristanovic R., Whisler W. W., Jr Prevalence of psychologic disorders after surgical treatment of seizures. Arch Neurol. 1988 Dec;45(12):1308–1311. doi: 10.1001/archneur.1988.00520360026006. [DOI] [PubMed] [Google Scholar]
  13. Mendez M. F., Cummings J. L., Benson D. F. Depression in epilepsy. Significance and phenomenology. Arch Neurol. 1986 Aug;43(8):766–770. doi: 10.1001/archneur.1986.00520080014012. [DOI] [PubMed] [Google Scholar]
  14. Naylor A. S., Rogvi-Hansen Bá, Kessing L., Kruse-Larsen C. Psychiatric morbidity after surgery for epilepsy: short-term follow up of patients undergoing amygdalohippocampectomy. J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1375–1381. doi: 10.1136/jnnp.57.11.1375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Perini G. I., Tosin C., Carraro C., Bernasconi G., Canevini M. P., Canger R., Pellegrini A., Testa G. Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy. J Neurol Neurosurg Psychiatry. 1996 Dec;61(6):601–605. doi: 10.1136/jnnp.61.6.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Perrine K., Hermann B. P., Meador K. J., Vickrey B. G., Cramer J. A., Hays R. D., Devinsky O. The relationship of neuropsychological functioning to quality of life in epilepsy. Arch Neurol. 1995 Oct;52(10):997–1003. doi: 10.1001/archneur.1995.00540340089017. [DOI] [PubMed] [Google Scholar]
  17. Rausch R., Crandall P. H. Psychological status related to surgical control of temporal lobe seizures. Epilepsia. 1982 Apr;23(2):191–202. doi: 10.1111/j.1528-1157.1982.tb05067.x. [DOI] [PubMed] [Google Scholar]
  18. Ring H. A., Moriarty J., Trimble M. R. A prospective study of the early postsurgical psychiatric associations of epilepsy surgery. J Neurol Neurosurg Psychiatry. 1998 May;64(5):601–604. doi: 10.1136/jnnp.64.5.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sperling M. R., O'Connor M. J. Comparison of depth and subdural electrodes in recording temporal lobe seizures. Neurology. 1989 Nov;39(11):1497–1504. doi: 10.1212/wnl.39.11.1497. [DOI] [PubMed] [Google Scholar]
  20. Sperling M. R., O'Connor M. J., Saykin A. J., Phillips C. A., Morrell M. J., Bridgman P. A., French J. A., Gonatas N. A noninvasive protocol for anterior temporal lobectomy. Neurology. 1992 Feb;42(2):416–422. doi: 10.1212/wnl.42.2.416. [DOI] [PubMed] [Google Scholar]
  21. Spitzer R. L., Williams J. B., Gibbon M., First M. B. The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Arch Gen Psychiatry. 1992 Aug;49(8):624–629. doi: 10.1001/archpsyc.1992.01820080032005. [DOI] [PubMed] [Google Scholar]
  22. Taylor D. C. Mental state and temporal lobe epilepsy. A correlative account of 100 patients treated surgically. Epilepsia. 1972 Dec;13(6):727–765. doi: 10.1111/j.1528-1157.1972.tb05160.x. [DOI] [PubMed] [Google Scholar]
  23. Trimble M. R. Behaviour changes following temporal lobectomy, with special reference to psychosis. J Neurol Neurosurg Psychiatry. 1992 Feb;55(2):89–91. doi: 10.1136/jnnp.55.2.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Trimble M. R. Behaviour changes following temporal lobectomy, with special reference to psychosis. J Neurol Neurosurg Psychiatry. 1992 Feb;55(2):89–91. doi: 10.1136/jnnp.55.2.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Victoroff J. I., Benson F., Grafton S. T., Engel J., Jr, Mazziotta J. C. Depression in complex partial seizures. Electroencephalography and cerebral metabolic correlates. Arch Neurol. 1994 Feb;51(2):155–163. doi: 10.1001/archneur.1994.00540140061016. [DOI] [PubMed] [Google Scholar]
  26. Williams J. B., Gibbon M., First M. B., Spitzer R. L., Davies M., Borus J., Howes M. J., Kane J., Pope H. G., Jr, Rounsaville B. The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability. Arch Gen Psychiatry. 1992 Aug;49(8):630–636. doi: 10.1001/archpsyc.1992.01820080038006. [DOI] [PubMed] [Google Scholar]
  27. Zwil A. S., McAllister T. W., Cohen I., Halpern L. R. Ultra-rapid cycling bipolar affective disorder following a closed-head injury. Brain Inj. 1993 Mar-Apr;7(2):147–152. doi: 10.3109/02699059309008168. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES