Abstracts

RATIONALE: Candidates for temporal lobectomy comprise a group of epileptic patients refractory to medical treatment. Psychopathology is over-represented in this population. It is not clear if patient's psychiatric status influences the decision for temporal lobectomy. It is hypothesized that patients are offered temporal lobectomy based on their suitability for resection of the seizure focus and is not influenced by their psychiatric status. METHODS: Three hundred and fifty-eight epileptic patients refractory to medical treatment were assessed prospectively in an epilepsy investigation unit over a seven year period. Patients underwent detailed observation and recording of their seizures as well as standardized psychiatric assessment. Of this group, 274 patients had a temporal focus. RESULTS: One hundred and eighty-seven patients with a temporal focus (left temporal 100, right temporal 82 and bitemporal 5) were operated compared to 87 (left temporal 36, right temporal 26 and bitemporal 25) patients who were not operated. With the DSM-III-R criteria, 125/274 (45.6%) were found to have a psychiatric diagnosis. There were 80/187 (42.8%) patients with a psychiatric diagnosis in the operated group compared to 45/87 (51.7%) in those who were not operated. We tested whether getting operated on was dependent on whether the patient had either a DSM-III-R Axis I or Axis II diagnosis. There was no significant difference. CONCLUSIONS: It is concluded that the decision to perform temporal lobectomy at our centre did not differ among those with or without a psychiatric diagnosis.