Psychiatric assessment in temporal lobe epilepsy

D`ALESSIO L, SOLIS P, ODDO S, CONSALVO D, GIAGANTE B, SILVA W, CENTURIÓN E, SAIDON P, KOCHEN S.

Santiago de Chile

Congreso; XI Congreso Panamericano de Neurología.; 2003

Sociedad Panamericana de Neuroepidemiología.

Propose: The aim of this study  was to determined the current and past history of psychiatric disorders in 20 patients with refractory temporal lobe epilepsy and mesial sclerosis, 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 was also analyzed. Neuropsychological evaluation included: Wais  test for IQ, memory, language and executive function tests. Results: 45% had a current Axis I psychiatric disorder and 30% had criteria for personality disorders. Many patients have more than one diagnoses in Axis I. The most common psychiatric disorders in Axis I were: Affective Disorders (77%), Impulsive Control Disorder (55%), and Anxiety Disorders (44%). Psychosis was diagnosed in 55%, but the most common type was post-ictal and transient psychosis (80%). Seven patients of the group with psychiatric co morbidity (77%) have a right epileptic focus, and none have an IQ lower than 70. Conclusion: Psychiatric disorders are frequent in patients with refractory temporal lobe epilepsy. Severe forms of psychiatric disorders included Axis I and Axis II co morbidity.