Epilepsy surgery: the worse the outcome, the greater the impulsivity?

STIVALA EG, NASIMBERA A, WOLFZUN C, SARUDIANSKY M, GIAGANTE B, SEOANE P, KOCHEN S, D`ALESSIO L.

Buenos Aires

Congreso; Encuentro SAN 2021; 2021

Sociedad Argentina de Neurociencia

Purpose: Psychiatric comorbidity in patients with resistant epilepsy is very common and often develop post-surgical psychiatric disorders. Impulsivity may be present and deepen the disorder’s severity. We analyze the post-surgical evolution and degree of impulsivity in these patients. Method: We included patients operated and assessed with a neurological, neuropsychological, psychiatric assessments, VEEG, MRI. One year after surgery, Barratt Impulsivity Scale was administered to the patients’ follow-up. Student's t-test and chi-square were performed. Result: 38 patients were included (21 women). 24 patients (63%) presented pre-surgical psychiatric disorders, either current or past. A pre-surgical psychiatric diagnosis was associated with the development of post-surgical psychiatric disorders. Lower GAF scores were correlated with higher impulsivity scores. A post-surgical diagnosis was associated with higher motor and total impulsivity scores. The evolution of postsurgical epileptic seizures, according to the Engel classification: Engel I (58%), II (21%), III, IV (21%). Worse postsurgical outcomes were associated with higher nonplanning impulsivity score. Conclusions: Post-surgical psychiatric comorbidities are more frequent in epileptic patients with a psychiatric history, being depression the most frequently diagnosed. Additionally, de novo postsurgical psychiatric disorders are infrequent. Nonplanning is strongly correlated with seizure outcome following surgery.