Abstracts

Rationale: Psychiatric conditions are very prevalent in patients with epilepsy mainly mood and anxiety disorders (Ertekin et al., 2009; Guarnieri et al., 2009; Sperli et al., 2009; Tellez-Zenteno et al., 2007). Psychiatric co-morbidities have been recognized as an important predictor of seizure outcome after surgery, the presence of psychiatric disorders maybe associated with worse postsurgical prognosis (Kanner et al., 2009). In this cohort we wanted to evaluate if pre-surgical assessment and treatment of psychiatric disorders improves post-surgical outcome. Methods: This prospective cohort analysis included 24 patients who underwent neurosurgical intervention for intractable epilepsy at the South Texas Comprehensive Epilepsy Center (STCEC), between 2010 and 2011. The study was approved by the UTHSCSA IRB office. Demographic variables were evaluated such as age, gender, marital status, education level, and employment; while clinical variables included age at onset of epilepsy, etiology of epilepsy, presence of Axis I Disorders were assess using the Mini International Neuropsychiatric Interview (MINI PLUS), use of psychotropic medications, age at surgery, and area of resection. Outcome variables include presence of seizures and psychiatric disorders at 1 and 3 months after surgery Results: The majority of patients were male (60.8%), single (43%), with a high school degreed (70.8%). Ninety two percent had MRI findings; in 54% the etiology was unknown. The majority of the resections were in the right hemisphere (54%). Mean age at time of resection was 33.36 years. Depressive mood was diagnosed in 41.6%, followed by anxiety in 37.5%. In 58% of patients psychotropic medications were prescribed. One month after resection, 83% (n=20) of the patients were seizure-free, 41.6% (n=10) met criteria for Major Depressive Disorder (MDD), 12.5% (n=3) were newly diagnosed. See Table 1 for psychiatric diagnosis of patients prior to and following resection. At 3-month follow-up, 37.5% (n=9) of the patients remained depressed, 20.8%(n=5) were taking antidepressants, and 83% (n=20) were seizure free. All the patients that met criteria for depression were seizure free.Conclusions: In this cohort we found that the prevalence of psychiatric disorders before and after surgery is high besides proper psychiatric intervention, and seizure outcome.