Psychiatric assessment of candidates for epilepsy surgery

Patients with medically intractable epilepsy often present with comorbid psychiatric diseases. When referred to a program for the surgical treatment of the epilepsies, these patients benefit from a pre-admission psychiatric assessment with a view to lessen the chances of a psychiatric crisis during the pre- and postoperative investigations. This article proposes a practical approach to the psychiatric assessment and monitoring of adult candidates to the surgery of epilepsy. It emphasizes, in agreement with a world literature review, that definitive psychiatric contraindications to this elective surgery are few, and that adverse long-term psychiatric outcomes are less frequent when good seizure outcome is achieved.