Psychopathology in children before and after surgery for extratemporal lobe epilepsy
M Chiara Colonnelli1, J Helen Cross, Sharon Davies
1Neuroscience Department, UCL Institute of Child Health & Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Insights
Psychiatric disorders are common in children with extratemporal epilepsy. Epilepsy surgery outcomes for mental health varied, with some children improving and others developing new diagnoses.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
Background:
- Extratemporal epilepsy is a significant neurological condition in children.
- Psychiatric comorbidities are frequently observed in pediatric epilepsy populations.
Purpose of the Study:
- To determine the prevalence and types of psychiatric disorders in children before and after extratemporal epilepsy surgery.
- To investigate the relationship between psychiatric morbidity and clinical/demographic factors.
Main Methods:
- Retrospective review of 71 children undergoing extratemporal focal resection for drug-resistant epilepsy (1997-2008).
- Psychiatric diagnoses were assessed using DSM-IV criteria pre- and postoperatively.
Main Results:
- 52% of children had mental health problems pre- and/or postoperatively.
- Preoperative psychiatric diagnoses were present in 44% and postoperative in 45% of children.
- Surgical impact on psychiatric symptoms was unpredictable, with varied outcomes.
Conclusions:
- Psychopathology is highly prevalent in children with extratemporal epilepsy.
- Epilepsy surgery does not predictably alter psychiatric status in all children.
- Early detection and management of mental health issues are crucial for this patient group.
Aim:
To establish the rates and types of psychiatric disorder in children before and after surgery for extratemporal epilepsy. Relationships between psychiatric morbidity and demographic/clinical variables were examined.
Method:
A retrospective case note review of 71 children undergoing extratemporal focal resection for drug resistant epilepsy in a specialist epilepsy surgery programme between 1997 and 2008. Psychiatric diagnoses were derived from pre- and postoperative assessments according to DSM-IV criteria.
Results:
Seventy-one children (38 males, 33 females) were eligible for this study. Mean age (SD) at surgery was 9 (5) years. Frontal resections were performed in 73% of the children, parietal in 17%, and occipital in 10%. Mental health problems were present in 37 of 71 (52%) children pre- and/or postoperatively. A similar proportion of children had psychiatric diagnoses pre- and postoperatively: 31 of 71 (44%) and 32 of 71 (45%) respectively.
Interpretation:
Psychopathology is common in children with extratemporal epilepsy. In this sample, the impact of surgery on psychiatric symptoms was not predictable: some children were unchanged, others improved, and others acquired new psychiatric diagnoses postoperatively. Given the high rates of psychiatric disorder in this group of patients, detection and treatment of mental health needs may be important.
