Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2016  |  Volume : 19  |  Issue : 3  |  Page : 377-380

Does antiepileptic drug withdrawal predispose patients undergoing temporal lobe epilepsy surgery to late onset of psychiatric morbidity? A report of three cases


1 Deptarment of Neurology, All India Institute of Medical Sciences, New Delhi, India
2 Deptarment of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
3 Deptarment of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
4 Deptarment of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Garima Shukla
Department of Neurology, Room #2, 6th Floor, Neurosciences Center, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.186828

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Surgery is an established and increasingly utilized treatment option in medically refractory temporal lobe epilepsy. Many psychiatric problems are known to complicate in the postoperative period. Most studies have a follow-up period of less than 24 months. We report the cases of three patients who developed severe psychiatric problems in the late postoperative period after successful temporal lobectomy for refractory epilepsy - Psychosis, major depression with psychosis, and severe anxiety disorder, respectively. None of the patients had past or family history of psychiatric disease. All three patients had undergone anterior temporal lobectomy on the right side for intractable epilepsy. They remained absolutely seizure-free after surgery. We conclude that psychiatric morbidity may arise de novo long after temporal lobectomy. This association between temporal lobectomy for epilepsy and late onset psychiatric morbidity should be carefully studied. Mechanisms underlying this late complication require deeper understanding of the effects of epilepsy surgery.


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