Abstracts

The present study aims to report and discuss development of obsessive-compulsive diorder (OCD) in a patient with temporal lopbe epilepsy and right mesial temporal sclerosis following temporal lobectomy with seizure remission. Case Report. JAC, 47 years, caucasian, catholic, antecedant of two non-febrile seizures at age two years, onset of epilepsy at age seven years, with seizures carachterized by [quot]icy feeling[quot] of both leggs with upper abdominal progression, followed by leg weakness, fear, loss of contact, motor automatisms and secondary generalization. EEG, MRI and SPECT disclosed right mesial temporal sclerosis. Neuropsychological evaluation showed lower efficiency of visual functions as compared to verbal. There was no history of psychiatric disorders. In july 2003 an anterior temporal lobectomy was performed because of refractory epilepsy. The patient coursed without neurologic complications and with seizure remission. However, two weks later, she presented obsessive religious thoughts of negative content such as ofensive swearing directed to religious icons, followed by compulsive behavior carachterized by repetiteve head movements carried out to alleviate or shun these disagreable thoughts. Worsening of previous psychiatric disorders as well as development od de novo diorders may occur after epilepsy surgery. Mostly, depression, psychosis and suicide attempts have been reported. OCD may occur associated with epilepsy with reports of improvement after epilepsy surgery. However, development of this disorder in patients without previous psychiatric diagnoses, following anterior temporal lobe resection is rare, and to our knowledge only two such cases had been published before.