IBCN   20355
INSTITUTO DE BIOLOGIA CELULAR Y NEUROCIENCIA "PROFESOR EDUARDO DE ROBERTIS"
Unidad Ejecutora - UE
congresos y reuniones científicas
Título:
Two years follow up after epilepsy surgery in patients with a history of presurgical psychosis
Autor/es:
D' ALESSIO L, SCÉVOLA L, FERNANDEZ LIMA M, KONOPKA H, SEOANE E, ODDO S, KOCHEN S
Lugar:
Montreal
Reunión:
Congreso; 30th Epilepsy Congress, Montreal, Canadá. 23-27 Junio 2013.; 2013
Institución organizadora:
ILAE
Resumen:
Introduction: Refractory temporal lobe epilepsy (RTLE) has been associated with a high incidence of psychotic disorders before and after epilepsy surgery. However there are many controversies in the literature; while some patients get better after surgery from their psychiatric condition, others develop de novo depression or psychosis. Objectives: The aim of this study was to determine the psychiatric outcome after epilepsy surgery in patients with a previous history of psychoses according Axis I criteria of DSM IV. Methods: Patients with RTLE and a positive history of psychoses were included in this study. A follow up during two years after surgery was determined. All patients underwent a complete clinical, electrophysiological, and image evaluation to determine surgical procedure. DMS IV Structural Interview for psychiatric disorders for Axis I and II in combination with Ictal classification for psychosis was used to determine psychiatric diagnoses before and after epilepsy surgery. Engel classification was used to determine the epilepsy outcome after surgery. Results During 2000-2010, 82 patients were admitted to the RMEC (Ramos Mejia Epilepsy Center) program for epilepsy surgery, and completed the psychiatric assessment protocol before surgery. From this population 13p/15% with RTLE had a positive history of psychoses (Axis I of DSM IV). Most common psychosis type before surgery was brief psychotic episode diagnosed in 8p/61.5%. During the first two years after surgery, 5 p/38.4% did not developed psychosis and improved from the previous psychiatric condition, 5 p/38.4% developed psychotic symptoms, similar to those presented previous to surgery, and 3p/23% developed other psychiatric condition after surgery (depression). Engel class I-II was determined in 9p/69%. Conclusions While some patients with a history of psychotic disorders get better from psychoses after epilepsy surgery, others continue having psychotic symptoms, or developed other psychiatric condition such as depression. More research in this area is needed.