PMID- 28378900
OWN - NLM
STAT- MEDLINE
DCOM- 20170713
LR  - 20180107
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Linking)
VI  - 58
IP  - 6
DP  - 2017 Jun
TI  - Psychiatric lifetime diagnoses are associated with a reduced chance of seizure 
      freedom after temporal lobe surgery.
PG  - 983-993
LID - 10.1111/epi.13736 [doi]
AB  - OBJECTIVE: To examine whether psychiatric comorbidity is a predictor of long-term 
      seizure outcome following temporal lobe epilepsy surgery. METHODS: A sample of 
      434 adult patients who received temporal lobe resection to treat epilepsy between 
      1991 and 2009 and were psychiatrically assessed before surgery were followed for 
      2 years to assess seizure outcome. Stepwise multivariate logistic regression 
      analyses were used to assess the impact of psychiatric variables on complete 
      seizure freedom (Engel class IA), and freedom from disabling seizures (Engel 
      class I). Lifetime histories of three psychiatric syndromes (PS: psychosis; 
      depression; other) and five personality disorders (PD: DSM-IV Clusters A, B, and 
      C; organic personality disorder; other) were considered as predictors, 
      complemented by age at onset, duration of epilepsy, type of lesion (mesiotemporal 
      sclerosis vs. other), and year of surgery. RESULTS: Seizure-freedom rates were 
      significantly higher (p < 0.001) in patients with no history of PS or PD 
      (N = 138; Engel class IA: 61.6%; Engel class I: 87.7%) than in those with any PS 
      or PD (N = 296; Engel class IA: 39.5%; Engel class I: 58.8%). Particularly low 
      seizure-freedom rates were found in patients with a diagnosis of psychosis 
      (N = 32, Engel class IA: 21.9%; Engel class I: 40.6%), organic PD (N = 48, Engel 
      class IA: 25.0%; Engel class I: 35.4%) or a double diagnosis of PS plus PD 
      (N = 97; Engel class IA: 27.8%; Engel class I: 45.5%). No other variables emerged 
      as significant risk factors in multivariate logistic regression analyses. 
      SIGNIFICANCE: Patients with and without psychiatric comorbidities can benefit 
      from temporal lobe epilepsy surgery; however, psychiatric comorbidities are 
      negatively associated with postoperative seizure-freedom rates. Surgical outcome 
      is related to the type and extent of preoperative psychiatric morbidity, which 
      underscores the prognostic value of presurgical psychiatric evaluation. The data 
      support the argument that there are common pathogenetic mechanisms underlying 
      both epilepsy and psychiatric conditions.
CI  - Wiley Periodicals, Inc. (c) 2017 International League Against Epilepsy.
FAU - Koch-Stoecker, Steffi C
AU  - Koch-Stoecker SC
AD  - Department of Psychiatry and Psychotherapy, Evangelical Clinic Bethel, Bielefeld, 
      Germany.
FAU - Bien, Christian G
AU  - Bien CG
AD  - Epilepsy Center Bethel, Krankenhaus Mara, Bielefeld, Germany.
FAU - Schulz, Reinhard
AU  - Schulz R
AD  - Epilepsy Center Bethel, Krankenhaus Mara, Bielefeld, Germany.
FAU - May, Theodor W
AU  - May TW
AD  - Society for Epilepsy Research, Epilepsy Center Bethel, Bielefeld, Germany.
LA  - eng
PT  - Journal Article
DEP - 20170405
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
SB  - IM
CIN - Epilepsy Curr. 2017 Nov-Dec;17 (6):351-352. PMID: 29217975
MH  - Adult
MH  - Anterior Temporal Lobectomy
MH  - Comorbidity
MH  - Depressive Disorder/diagnosis/epidemiology
MH  - Dominance, Cerebral/physiology
MH  - Epilepsy, Temporal Lobe/*diagnosis/*epidemiology/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Germany
MH  - Humans
MH  - Male
MH  - Mental Disorders/*diagnosis/*epidemiology/physiopathology
MH  - Multivariate Analysis
MH  - Neurocognitive Disorders/diagnosis/epidemiology/physiopathology
MH  - Personality Disorders/diagnosis/epidemiology
MH  - Postoperative Complications/*diagnosis/*epidemiology/physiopathology
MH  - Prognosis
MH  - Psychotic Disorders/diagnosis/epidemiology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Anterior temporal lobectomy
OT  - Mental disorders
OT  - Personality disorders
OT  - Temporal lobe epilepsy
OT  - Treatment outcome
EDAT- 2017/04/06 06:00
MHDA- 2017/07/14 06:00
CRDT- 2017/04/06 06:00
PHST- 2017/02/26 00:00 [accepted]
PHST- 2017/04/06 06:00 [pubmed]
PHST- 2017/07/14 06:00 [medline]
PHST- 2017/04/06 06:00 [entrez]
AID - 10.1111/epi.13736 [doi]
PST - ppublish
SO  - Epilepsia. 2017 Jun;58(6):983-993. doi: 10.1111/epi.13736. Epub 2017 Apr 5.