Side and Site of Brain Surgery Affects Psychological Outcome

Posted Feb 8 2017 in Conditions related to epilepsy

The side and site of epilepsy surgery affects its psychological outcome according to a new study published in the journal Epilepsy and Behavior.

This finding highlights the importance of considering psychological changes that may occur as a result of epilepsy surgery, on an individual patient basis.

According to the authors, further studies are needed to identify potential risk factors that may make the symptoms of surgery more severe. Further research could also help provide patients with counselling before surgery and identify those who may be most in need of psychological surveillance following surgery.

For the study, the team of researchers led by Dr Robyn Busch, a clinical psychologist at Cleveland Clinic Epilepsy Centre analysed 228 adults with epilepsy who underwent temporal lobe or frontal lobe brain surgery. The patients completed the Personality Assessment Inventory (PAI), which provides an objective assessment of adult psychological problems, both before and after surgery.

The researchers then compared the psychological outcome of the operation between people who had surgery on the left side of their brain versus those who had right-sided surgery.

They found that people with left temporal lobe epilepsy had higher PAI scores (i.e. more psychological problems) before the operation compared to those with left frontal lobe epilepsy. Following surgery, the psychological problems, which included anxiety and depression, usually improved although a small subset of patients reported that their symptoms became worse after surgery. The most frequent improvements were seen in those undergoing temporal lobe surgery.

The researchers concluded that the side and site of brain surgery in epilepsy are important factors in determining the psychological outcome of the operation in adults. They stress that it is important to identify the risk factors that may be associated with the worsening of the symptoms seen in a subset of patients after surgery.

It is estimated that 20 to 40% of people with epilepsy are diagnosed with at least one form of psychological disorder and this percentage can be as high as 70% in people with drug resistant epilepsy. Previous studies have shown that depression is more frequent in people with a seizure focus on the left side of the brain.

Author: Dr Özge Özkaya

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