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Psychiatric comorbidity in temporal DNET and improvement after surgery.

A Landais1, A Crespel2, J-L Moulis3

  • 1Neurology Department, University Hospital of Pointe-à-Pitre, 97139 Abymes, Guadeloupe.

Neuro-Chirurgie
|May 31, 2016
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Summary
This summary is machine-generated.

Patients with temporal lobe epilepsy (TLE) and dysembryoplastic neuroepithelial tumors (DNET) often experience psychiatric disorders. Surgery significantly improved these conditions, suggesting it is a viable treatment even with pre-existing psychiatric issues.

Keywords:
Chirurgie de l’épilepsieDNETEpilepsy surgeryPsychiatric disordersTroubles psychiatriques

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Area of Science:

  • Neurology
  • Psychiatry
  • Neurosurgery

Background:

  • Temporal lobe epilepsy (TLE) is associated with psychiatric disorders, potentially linked to "alien tissue."
  • Ganglioglioma and dysembryoplastic neuroepithelial tumors (DNET) may increase the risk of post-surgical psychoses.
  • Severe psychiatric disorders have traditionally contra-indicated epilepsy surgery.

Purpose of the Study:

  • To assess inter-ictal psychiatric disorders in patients with temporal DNET before and after epilepsy surgery.
  • To evaluate the long-term outcomes (minimum 2-year follow-up) of psychiatric conditions in these patients.

Main Methods:

  • Histological confirmation of DNETs.
  • Classification of psychiatric disorders using DSM-IV-TR criteria.
  • Prospective evaluation of 10 consecutive patients with temporal DNET.

Main Results:

  • Five patients (50%) presented with inter-ictal psychiatric disorders, including schizophrenia, borderline personality disorder, intermittent explosive disorder, and other personality disorders.
  • Significant improvement in psychiatric conditions was observed post-surgery in these five patients.
  • No new psychiatric behaviors or de novo psychoses occurred after surgery.

Conclusions:

  • Inter-ictal psychiatric disorders are prevalent in temporal lobe DNET patients, often manifesting as personality and behavioral issues with impulsivity and verbal aggression.
  • Epilepsy surgery appears to be a safe and effective treatment for temporal lobe DNET, even in patients with pre-existing psychiatric disorders.
  • Severe psychiatric disorders should not be considered an absolute contra-indication for epilepsy surgery in DNET patients.