KOCHEN Sara Silvia
Presurgical psychiatric assessment in patients with refractory epilepsy
D´ALESSIO L, ODDO S, SOLÍS P, GIAGANTE B, SILVA W, CONSALVO D, ZIEHER L, KOCHEN S
Revista Mexicana de Neurociencia
Año: 2004 p. 210 - 210
Propose: The aim of this study is to determine the current and past history of psychiatric disorders in 75 patients with refractory epilepsy included in the epilepsy surgical program. Methods: The past and current psychiatric disorders were determined using the Structural Interview, SCID I and II of DSM IV. Pharmacological history, suicide attempts, and psychiatric institutionalization were also analyzed. Results: Three groups of patients were analyzed: 65 patients with temporal epilepsy, 5 with frontal epilepsy, and 5 with other no frontal no temporal epilepsy. In temporal group, 55% had disorders in Axis I, and 29% had criteria for Axis II disorders. In frontal group 100% had Axis I disorders, and 20% Axis II. In the third group, 80% had Axis I disorders and 40% Axis II. The most common Axis I disorders were Affective, Anxiety, Impulsive and Psychotic Disorders. Suicide Attempts and psychiatric institutionalization were frequent in Temporal (18%), and Frontal group( 60%). Fourteen patients of this report underwent surgery, and all of them were evaluated after surgery during 1 year. 5 p. (36%) required psychopharmacological therapy because of the novo psychiatric disorders but 6p. (43%) with presurgical psychiatric disorders, were relief of psychiatric symptoms. Conclusion: Psychiatric disorders are frequent in patients with refractory epilepsy and severe forms of psychiatric disorders required psychiatric treatment before decided surgery. While some patients may get better of psychiatric symptoms after surgery others required psychiatric therapy.