Journal articles: 'Surgery, epilepsy, anxiety'

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Halley, Sophia A., Joanne M. Wrench, David C. Reutens, and Sarah J. Wilson. "The amygdala and anxiety after epilepsy surgery." Epilepsy & Behavior 18, no. 4 (August 2010): 431–36. http://dx.doi.org/10.1016/j.yebeh.2010.05.003.

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Qualmann, Krista J., Christine G. Spaeth, Melanie F. Myers, Paul S. Horn, Katherine Holland, Francesco T. Mangano, and Hansel M. Greiner. "Pediatric Epilepsy Surgery." Journal of Child Neurology 32, no. 5 (January 6, 2017): 467–74. http://dx.doi.org/10.1177/0883073816685653.

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Central nervous system comorbidities have been identified in patients with epilepsy. Several of these comorbidities have been correlated with poor surgery outcomes in patient cohorts. The authors sought to determine if prevalence of comorbidities in pediatric epilepsy surgery patients and their families correlate with long-term seizure outcome in a cross-sectional analysis. Three-generation pedigrees were elicited to compare family history of epilepsy, ADHD, anxiety, autism, bipolar disorder, cognitive disability, depression, migraine, and motor disability to surgery outcomes in 52 patients. Proportions of affected patients and relatives were compared to general population comorbidity rates and the patients’ most recent seizure outcome classification. Patients and families had significantly higher rates of comorbidities than the general population. Poorer long-term seizure outcomes following resective surgery were associated with autism or cognitive disability in patients. Together these data support evidence for a common pathophysiological mechanism between epilepsy and central nervous system comorbidities.

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Salgado, Priscila Camile Barioni, and Fernando Cendes. "Life adjustment after surgical treatment for temporal lobe epilepsy." Journal of Epilepsy and Clinical Neurophysiology 15, no. 2 (June 2009): 71–75. http://dx.doi.org/10.1590/s1676-26492009000200005.

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OBJECTIVE: The purpose of this study was to evaluate the patients' life adjustment after epilepsy surgery, through instruments of quality of life (QoL), anxiety, depression, preoperative expectations and postoperative life changing. METHODS: Thirty-six adults who underwent temporal lobe epilepsy surgery were interviewed before surgery, and 6 and 12 months after surgery. RESULTS: For all patients, epilepsy surgery gave rise to an evolving process of postoperative adjustment, what means that they were satisfied with surgery results, and that their expectations were reached. The improvement was seen in their QoL (p=0.004), anxiety (p=0.019) and depression (p=0.001), which was associated to their perception of positive life changing. The inexistence of depressive and anxiety symptoms and the good QoL after surgery predicted the perception of positive life changing. This study could predict a total of 56.5% of aspects involved in the perception of positive life changing after epilepsy surgery, what seems that other variables may be involved in this process. The patients' status before surgery (expectations, QoL, anxiety, depression and seizures frequency) did not predict the life satisfaction after surgery, what means that when patients evaluate their actual lives they do it looking for daily aspects and do not tend to compare to their lives before surgery. CONCLUSION: The findings of the present study have implications for the evaluation of life adjustment postsurgery, calling attention to measures of preoperative expectations, anxiety, depression and QoL. The strength of these contributions highlights the importance of registering the patients' feelings and opinions during the presurgical evaluation and may help the health providers to understand the aspects necessary to improve the patients' quality of life.

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Jackson, M. J. "Depression and anxiety in epilepsy." Journal of Neurology, Neurosurgery & Psychiatry 76, suppl_1 (March 1, 2005): i45—i47. http://dx.doi.org/10.1136/jnnp.2004.060467.

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Gadgil, Nisha, Melissa A. LoPresti, Matthew Muir, Jeffrey M. Treiber, Marc Prablek, Patrick J. Karas, and Sandi K. Lam. "An update on pediatric surgical epilepsy: Part I." Surgical Neurology International 10 (December 27, 2019): 257. http://dx.doi.org/10.25259/sni_417_2019.

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Epilepsy affects many children worldwide, with drug-resistant epilepsy affecting 20–40% of all children with epilepsy. This carries a significant burden for patients and their families and is strongly correlated with poor cognitive outcomes, depression, anxiety, developmental delay, and impaired activities of daily living. For this reason, we sought to explore the role of pediatric epilepsy surgery and provide an overview of the factors contributing to epilepsy surgery planning and execution. We review the necessary preoperative evaluations, surgical indications, planning considerations, and surgical options to provide a clear pathway in the evaluation and planning of pediatric epilepsy surgery.

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Pintea, Bogdan, Rainer Surges, and Jan Boström. "Headache Perception in an Epilepsy Patient with Neuromodulation by Anterior Thalamic Nuclei Deep Brain Stimulation: A Case Report." Journal of Neurological Surgery Part A: Central European Neurosurgery 81, no. 04 (March 16, 2020): 368–71. http://dx.doi.org/10.1055/s-0039-1685508.

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Abstract Objective Headache disorders are frequently associated with epilepsy. Some neuromodulation techniques for refractory epilepsy have been reported to positively influence the associated chronic headache. However, the exact mechanism of action of vagus nerve stimulation (VNS) and anterior thalamic nuclei-deep brain stimulation (ANT-DBS) on pain perception is unclear. Method We report a structured assessment of pain perception in a patient who experienced headache relief after ANT-DBS for refractory focal epilepsy and compare it with pain perception of epilepsy patients with chronic headache who were treated with and without VNS. Results The pain-associated symptoms in the ANT-DBS case were on the Pain Anxiety Symptoms Scale (PASS-40) subscore “physiological anxiety” closer to the control collective, whereas in patients with VNS, this was more likely for the PASS-40 subscores “cognitive anxiety” or “escape and avoidance.” Conclusion ANT-DBS and VNS may influence epilepsy-associated chronic headache in different ways.

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REUBER, MARKUS, BJÖRN ANDERSEN, CHRISTIAN E. ELGER, and CHRISTOPH HELMSTAEDTER. "Depression and anxiety before and after temporal lobe epilepsy surgery." Seizure 13, no. 2 (March 2004): 129–35. http://dx.doi.org/10.1016/s1059-1311(03)00073-6.

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Devinsky, O., W. B. Barr, B. G. Vickrey, A. T. Berg, C. W. Bazil, S. V. Pacia, J. T. Langfitt, et al. "Changes in depression and anxiety after resective surgery for epilepsy." Neurology 65, no. 11 (December 12, 2005): 1744–49. http://dx.doi.org/10.1212/01.wnl.0000187114.71524.c3.

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Radaelli, Graciane, Fernanda Majolo, Eduardo Leal-Conceição, Francisco de Souza Santos, Vinícius Escobar, Gabriele Goulart Zanirati, Mirna Wetters Portuguez, Fulvio Alexandre Scorza, and Jaderson Costa da Costa. "Left Hemisphere Lateralization of Epileptic Focus Can Be More Frequent in Temporal Lobe Epilepsy Surgical Patients with No Consensus Associated with Depression Lateralization." Developmental Neuroscience 43, no. 1 (2021): 1–8. http://dx.doi.org/10.1159/000513537.

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Temporal lobe epilepsy (TLE) is considered to be the most common form of epilepsy, and it has been seen that most patients are refractory to antiepileptic drugs. A strong association of this ailment has been established with psychiatric comorbidities, primarily mood and anxiety disorders. The side of epileptogenic may contribute to depressive and anxiety symptoms; thus, in this study, we performed a systematic review to evaluate the prevalence of depression in TLE in surgical patients. The literature search was performed using PubMed/Medline, Web of Science, and PsycNet to gather data from inception until January 2019. The search strategy was related to TLE, depressive disorder, and anxiety. After reading full texts, 14 articles meeting the inclusion criteria were screened. The main method utilized for psychiatric diagnosis was Diagnostic and Statistical Manual of Mental Disorders/Structured Clinical Interview for DSM. However, most studies failed to perform the neuropsychological evaluation. For those with lateralization of epilepsy, focus mostly occurred in the left hemisphere. For individual depressive diagnosis, 9 studies were evaluated, and 5 for anxiety. Therefore, from the data analyzed in both situations, no diagnosis was representative in preoperative and postoperative cases. In order to estimate the efficacy of surgery in the psychiatry episodes and its relation to seizure control, the risk of depression and anxiety symptoms in epileptic patients need to be determined before surgical procedures. Rigorous preoperative and postoperative evaluation is essential for psychiatry conditions in patients with refractory epilepsy candidates for surgery.

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Zhang, Bo, Weijie Wang, Shenguo Wang, Shaoping Li, Mingchao Liu, Lantian Wang, and Caijun Yang. "Clinical Study on Electronic Medical Neuroelectric Stimulation Based on the Internet of Things to Treat Epilepsy Patients with Anxiety and Depression." Journal of Healthcare Engineering 2021 (March 17, 2021): 1–13. http://dx.doi.org/10.1155/2021/6667309.

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With the continuous development and improvement of the level of medical technology in our country in recent years, the treatment of epilepsy has been constantly updated and developed. Nerve electrical stimulation is considered to be a very effective method for treating epilepsy with anxiety and depression. There are many traditional methods for the treatment of epilepsy. For example, vagus nerve stimulation (VNS) has been applied earlier, and the therapeutic effect has been confirmed, but it will cause serious complications and is easier to be uncomfortable; deep brain stimulation for epilepsy is still in the immature stage, and there is no final conclusion. Therefore, this article proposes a clinical study on the treatment of patients with epilepsy with anxiety and depression based on the electronic medical nerve stimulation of the Internet of Things. First of all, this article uses the literature method to study the causes of epilepsy and previous treatment methods. Then, we designed an experimental study of epilepsy with depression based on the Internet of Things electronic medical neuroelectric stimulation therapy and selected the core quality of life questionnaire, SDS, and SAS as observation indicators. Finally, the comparison of epilepsy symptoms and depression and anxiety between the control group and the observation group before and after treatment was analyzed. The results of the experiment showed that, among the 50 subjects in the study, the observation group that used electrical nerve stimulation therapy had 5 people who stopped seizures after treatment, accounting for 10%, while in the control group of traditional drug treatment methods, after treatment, only one person stopped the seizure, accounting for 2%. In addition, the SAS and SDS scores of the observation group were also lower than those of the control group. Therefore, the use of nerve electrical stimulation to treat epilepsy with anxiety and depression symptoms has better performance and can help patients recover as soon as possible.

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Taskiran, Emine, Zeliha Matur, Günay Gül, Nerses Bebek, Betül Baykan, Ayşen Gökyigit, and Candan Gürses. "The Impact of Affective State on Quality of Life in Focal Epilepsy in Turkey." Journal of Neurosciences in Rural Practice 10, no. 02 (April 2019): 267–72. http://dx.doi.org/10.4103/jnrp.jnrp_324_18.

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ABSTRACT Context: Seizures and accompanying situations including social, medical, and psychiatric problems threaten the quality of life (QOL) in patients with epilepsy. The World Health Organization defines health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. Aims: This study examines the prevalence of both depression and anxiety symptoms and also impact of the affective state on QOL in patients with focal epilepsy in Turkey. Settings and Design: One hundred and five patients with focal epilepsy over 18 years old were included in this study. The patients were classified into four groups according to the presence of AS and seizure control. Subjects and Methods: Patients’ affective symptoms (AS) and QOL were examined using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and QOL in Epilepsy Inventory-31 (QOLIE-31). Statistical Analysis Used: We used descriptive statistics, Chi-square test, independent samples t-test, one-way analysis of variance, Mann–Whitney U-test, Kruskal–Wallis H-test, and also Pearson’s and Spearman’s correlation test for correlations. Results: There were positive correlations between total QOLIE-31 score and epilepsy surgery, employment, and seizure freedom, whereas negative correlations were found with antiepileptic drug use, anxiety, and depression. Statistically significant differences were found in QOLIE-31 totals and subscores between Groups 3 and 4 (P < 0.05). Conclusions: The presence of AS has a negative impact on QOL in patients with focal epilepsy. Physicians should be aware that psychiatric comorbidities in epilepsy have a severe impact and epilepsy treatment requires comprehensive management.

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Mattsson, Peter, Bodil Tibblin, Margareta Kihlgren, and Eva Kumlien. "A prospective study of anxiety with respect to seizure outcome after epilepsy surgery." Seizure 14, no. 1 (January 2005): 40–45. http://dx.doi.org/10.1016/j.seizure.2004.02.009.

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Hamid, H., K. Blackmon, X. Cong, J. Dziura, L. Y. Atlas, B. G. Vickrey, A. T. Berg, et al. "Mood, anxiety, and incomplete seizure control affect quality of life after epilepsy surgery." Neurology 82, no. 10 (January 31, 2014): 887–94. http://dx.doi.org/10.1212/wnl.0000000000000183.

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Benevides, Maria Luiza, Jean Costa Nunes, Ricardo Guarnieri, Hiago Melo, Mariana Lunardi, Marcelo Neves Linhares, Emil Kupek, Peter Wolf, Kátia Lin, and Roger Walz. "Anxiety and depressive symptoms long after mesial temporal epilepsy surgery: A prospective study." Epilepsy & Behavior 118 (May 2021): 107936. http://dx.doi.org/10.1016/j.yebeh.2021.107936.

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Rampling, J., J. Jackson, J. Docker, T. Von Oertzen, H. Cock, A. J. Mitchell, and N. Agrawal. "038 Screening for anxiety and depression in epilepsy--preliminary findings." Journal of Neurology, Neurosurgery & Psychiatry 81, no. 10 (September 24, 2010): e15-e15. http://dx.doi.org/10.1136/jnnp.2010.217554.38.

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Smith, Jason A. D., Michelle Armacost, Emily Ensign, Susan Shaw, Nora Jimenez, David Millett, Charles Liu, and Christianne N. Heck. "Epilepsy surgery in the underserved Hispanic population improves depression, anxiety, and quality of life." Epilepsy & Behavior 83 (June 2018): 1–6. http://dx.doi.org/10.1016/j.yebeh.2018.03.015.

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Anderson, Christopher Todd, Eva Noble, Ram Mani, Kathy Lawler, and John R. Pollard. "Epilepsy Surgery: Factors That Affect Patient Decision-Making in Choosing or Deferring a Procedure." Epilepsy Research and Treatment 2013 (September 16, 2013): 1–13. http://dx.doi.org/10.1155/2013/309284.

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Surgical resection for well-selected patients with refractory epilepsy provides seizure freedom approximately two-thirds of the time. Despite this, many good candidates for surgery, after a presurgical workup, ultimately do not consent to a procedure. The reasons why patients decline potentially effective surgery are not completely understood. We explored the socio cultural, medical, personal, and psychological differences between candidates who chose (n = 23) and those who declined surgical intervention (n = 9). We created a novel questionnaire addressing a range of possible factors important in patient decision making. We found that patients who declined surgery were less bothered by their epilepsy (despite comparable severity), more anxious about surgery, and less likely to listen to their doctors (and others) and had more comorbid psychiatric disease. Patients who chose surgery were more embarrassed by their seizures, more interested in being “seizure-free”, and less anxious about specific aspects of surgery. Patient attitudes, beliefs, and anxiety serve as barriers to ideal care. These results can provide opportunities for education, treatment, and intervention. Additionally, patients who fit a profile of someone who is likely to defer surgery may not be appropriate for risky and expensive presurgical testing.

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Altalib, Hamada H., Anne T. Berg, Xiangyu Cong, Barbara G. Vickrey, Michael R. Sperling, Shlomo Shinnar, John T. Langfitt, et al. "Presurgical depression and anxiety are not associated with worse epilepsy surgery outcome five years postoperatively." Epilepsy & Behavior 83 (June 2018): 7–12. http://dx.doi.org/10.1016/j.yebeh.2018.01.040.

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Smith, Jason, Michelle Armacost, Emily Ensign, Susan Shaw, Nora Jimenez, and Charles Liu. "Improved Depression, Anxiety and Quality of Life in Hispanic Immigrants One-Year After Epilepsy Surgery." Archives of Physical Medicine and Rehabilitation 98, no. 10 (October 2017): e74-e75. http://dx.doi.org/10.1016/j.apmr.2017.08.234.

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Pope, Rebecca A., Pamela J. Thompson, Khadija Rantell, Jason Stretton, Mary-Anne Wright, and Jacqueline Foong. "Frontal lobe dysfunction as a predictor of depression and anxiety following temporal lobe epilepsy surgery." Epilepsy Research 152 (May 2019): 59–66. http://dx.doi.org/10.1016/j.eplepsyres.2019.03.003.

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Grzegorzewska, Agata M., Wiesław J. Cubała, and Mariusz S. Wiglusz. "Screening and diagnosis for mood and anxiety disorders in epilepsy: Polish population reference values." Neurologia i Neurochirurgia Polska 55, no. 4 (August 31, 2021): 351–56. http://dx.doi.org/10.5603/pjnns.a2021.0047.

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Noble, Adam J., James Reilly, James Temple, and Peter L. Fisher. "Cognitive-behavioural therapy does not meaningfully reduce depression in most people with epilepsy: a systematic review of clinically reliable improvement." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 11 (May 7, 2018): 1129–37. http://dx.doi.org/10.1136/jnnp-2018-317997.

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Psychological treatment is recommended for depression and anxiety in those with epilepsy. This review used standardised criteria to evaluate, for the first time, the clinical relevance of any symptom change these treatments afford patients. Databases were searched until March 2017 for relevant trials in adults. Trial quality was assessed and trial authors asked for individual participants’ pre-treatment and post-treatment distress data. Jacobson’s methodology determined the proportion in the different trial arms demonstrating reliable symptom change on primary and secondary outcome measures and its direction. Search yielded 580 unique articles; only eight eligible trials were identified. Individual participant data for five trials—which included 398 (85%) of the 470 participants randomised by the trials—were received. The treatments evaluated lasted ~7 hours and all incorporated cognitive-behavioural therapy (CBT). Depression was the primary outcome in all; anxiety a secondary outcome in one. On average, post-treatment assessments occurred 12 weeks following randomisation; 2 weeks after treatment had finished. There were some limitations in how trials were conducted, but overall trial quality was ‘good’. Pooled risk difference indicated likelihood of reliable improvement in depression symptoms was significantly higher for those randomised to CBT. The extent of gain was though low—the depressive symptoms of most participants (66.9%) receiving CBT were ‘unchanged’ and 2.7% ‘reliably deteriorated’. Only 30.4% made a ‘reliable improvement. This compares with 10.2% of participants in the control arms who ‘reliably improved’ without intervention. The effect of the treatments on secondary outcome measures, including anxiety, was also low. Existing CBT treatments appear to have limited benefit for depression symptoms in epilepsy. Almost 70% of people with epilepsy do not reliably improve following CBT. Only a limited number of trials have though been conducted in this area and there remains a need for large, well-conducted trials.

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Welton, Jeremy M., Christine Walker, Kate Riney, Alvin Ng, Lisa M. Todd, and Wendyl D’Souza. "008 Associations between comorbidities and adverse events of antiepileptic drugs and quality of life: a survey of epilepsy patients in australia." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A3.2—A3. http://dx.doi.org/10.1136/jnnp-2019-anzan.8.

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IntroductionThis study explored the impact of specific types of comorbidities and adverse events (AEs) from antiepileptic drugs (AEDs) on quality of life (QoL) among adult patients with epilepsy (PwE) in Australia.MethodsCross-sectional surveys were completed by PwE, or caregiver proxies, recruited via the online pharmacy application MedAdvisor and Australian PwE Facebook groups from May–August 2018 Data were collected on demographics, epilepsy severity and management, AEs, comorbidities, and QoL (using QOLIE-10-P total score).1 Multiple linear regression models were constructed to explore associations between AEs or comorbidities and QOLIE-10-P, with possible confounders determined using stepwise selection.Results978 responses were included (mean age 44.5 years, 64% female, 52% employed). 97% reported recent AED use, 47% on AED monotherapy, 35% exposed to ≤2 lifetime AEDs, and 55% seizure-free for >1 year. After stepwise selection, control variables included in both models were: time since diagnosis, employment status, seizure frequency, number of currently prescribed AEDs, and number of general practitioner visits per year. In the model for comorbidities, ‘psychiatric disorders’ was associated with the largest QOLIE-10-P decrease (-23.30, p<0.001). In the model for AEs, which additionally controlled for depression and anxiety disorder, ‘memory problems’ was associated with the largest decrease in QOLIE-10-P (-14.27, p<0.001).ConclusionsIn this survey of Australian PwE, of which many had relatively well-controlled epilepsy, psychiatric and memory problems were common and associated with the greatest detrimental impact on QoL. Further research is needed to understand causality, relationships between possibly interrelated or overlapping symptoms, and management strategies. UCB Pharma-sponsored.ReferenceCramer JA, Perrine K, Devinsky O, Meador K. A brief questionnaire to screen for quality of life in epilepsy: The QOLIE-10. Epilepsia 1996;37:577–582.

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Kutlu, Ayşe, Şehnaz Başaran, Nur Saadet Altun, Halil Ünalan, and Sezer Şener Komsuoğlu. "Quality of Life, Depression and Anxiety in Patients With Epilepsy: Controlled Study With Short Form 36 Questionnaire, Beck Depression Inventory, and Hamilton Anxiety Scale." Neurosurgery Quarterly 20, no. 2 (June 2010): 95–99. http://dx.doi.org/10.1097/wnq.0b013e3181dcb4ce.

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Boon, Paul, Philippe Ryvlin, James W. Wheless, and Kensuke Kawai. "Treating Drug-resistant Epilepsy – Why are we Waiting?" European Neurological Review 10, no. 2 (2015): 171. http://dx.doi.org/10.17925/enr.2015.10.02.171.

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Drug-resistant epilepsy (DRE) has been defined by the ad hoc Task Force of the International League Against Epilepsy (ILAE) Commission on Therapeutic Strategies as the failure of two appropriately chosen and tolerated anti-epileptic drugs (AEDs) (whether as monotherapy or in combination) to control seizures when used for an adequate period of time. The difference between the number of patients with DRE and the number of these patients who do not get access to adequate treatment is defined as the ‘treatment gap’, which is considered to be substantial. There are multiple possible causes that underlie the treatment gap in DRE: economic costs, natural history of epilepsy, deficiencies in health service provision, social stigma and other as yet unidentified causes. Factors affecting quality of life in DRE include depression and anxiety, raised risk of mortality and morbidity, increased healthcare utilisation and increased risk of adverse events with long- term use of AEDs, cognitive and memory impairment, seizure-related injuries, impaired ability to achieve educational and vocational goals, to drive, establish families and benefit from social relationships. Among the reasons for the greater risk of premature death are the raised risk of suicide in those patients with comorbid psychiatric disease and the increased incidence of sudden unexpected death among those with epilepsy. Managing epilepsy well involves more than just seizure reduction and when freedom from seizures cannot be achieved, addressing quality of life is likely to be more beneficial than interventions aimed at seizure reduction alone. Options exist for patients with DRE who are not candidates for epilepsy surgery, including dietary treatments, further attempts with AEDs and non-pharmacological interventions with devices. Further, non-invasive modalities are emerging, creating a more hopeful picture that the treatment gap for patients with DRE may be narrowed or even closed.

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Wilbur, Colin, Chinnuwat Sanguansermsri, Hedi Chable, Mihaela Anghelina, Sharon Peinhof, Kelly Anderson, Paul Steinbok, Ash Singhal, Anita Datta, and Mary B. Connolly. "Manifestations of Tuberous Sclerosis Complex: The Experience of a Provincial Clinic." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 44, no. 1 (November 7, 2016): 35–43. http://dx.doi.org/10.1017/cjn.2016.311.

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AbstractBackground: Tuberous sclerosis complex (TSC) is a neurocutaneous disorder with a wide spectrum of manifestations. Recent consensus recommendations stress the importance of multidisciplinary management of children with TSC. The objective of this study was to examine the manifestations of TSC at a large referral centre to determine the care needs of this population. Methods: A retrospective, systematic chart review was performed of children with TSC managed at British Columbia Children’s Hospital. Patients were identified through epilepsy and clinical neurophysiology databases. Results: The study population comprised 81 patients, born between 1987 and 2014, who were a median of 10 years (range, 0.2-23.2) at most recent follow-up. Epilepsy occurred in 91% of patients, including 32% with a history of infantile spasms. Nineteen patients underwent epilepsy surgery, nine (47%) of whom were seizure-free at most recent follow-up. Overall, 61% of epilepsy patients had been seizure-free for at least 1 year at the time of last follow-up. Neuropsychiatric disorders were diagnosed in 49% of children, with autism (25%), attention deficit hyperactivity order (19%) and anxiety (16%) being the most common. Cardiac rhabdomyomata occurred in 35% of children and renal angiomyolipomas were seen in 43%. A total of 91% had skin manifestations. Conclusion: This study outlines the multisystem manifestations of TSC, observed through a large pediatric referral center. Epilepsy and neuropsychiatric disorders are the major source of morbidity in this age group and provide many challenges to the treating clinician. Because a subset of the study population is still quite young, the prevalence of neuropsychiatric disorders is likely underestimated.

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Kanner, A. M. "EPILEPSY, DEPRESSION AND ANXIETY DISORDERS: A COMPLEX RELATION WITH SIGNIFICANT THERAPEUTIC IMPLICATIONS FOR THE THREE CONDITIONS." Journal of Neurology, Neurosurgery & Psychiatry 84, no. 9 (August 6, 2013): e1-e1. http://dx.doi.org/10.1136/jnnp-2013-306103.15.

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Abla, Adib A., Andrew G. Shetter, Steve W. Chang, Scott D. Wait, David G. Brachman, Yu-Tze Ng, Harold L. Rekate, and John F. Kerrigan. "Gamma Knife surgery for hypothalamic hamartomas and epilepsy: patient selection and outcomes." Journal of Neurosurgery 113, Special_Supplement (December 2010): 207–14. http://dx.doi.org/10.3171/2010.8.gks101027.

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Object The authors present outcomes obtained in patients who underwent Gamma Knife surgery (GKS) at 1 institution as part of a multimodal treatment of refractory epilepsy caused by hypothalamic hamartomas (HHs). Methods Between 2003 and 2010, 19 patients with HH underwent GKS. Eight patients had follow-up for less than 1 year, and 1 patient was lost to follow-up. The 10 remaining patients (mean age 15.1 years, range 5.7–29.3 years) had a mean follow-up of 43 months (range 18–81 months) and are the focus of this report. Five patients had undergone a total of 6 prior surgeries: 1 transcallosal resection of the HH, 2 endoscopic transventricular resections of the HH, 2 temporal lobectomies, and 1 arachnoid cyst evacuation. In an institutional review board–approved study, postoperative complications and long-term outcome measures were monitored prospectively with the use of a proprietary database. Seven patients harbored Delalande Type II lesions; the remainder harbored Type III or IV lesions. Seizure frequency ranged from 1–2 monthly to as many as 100 gelastic seizures daily. The mean lesion volume was 695 mm3 (range 169–3000 mm3, median 265 mm3). The mean/median dose directed to the 50% isodose line was 18 Gy (range 16–20 Gy). The mean maximum point dose to the optic chiasm was 7.5 Gy (range 5–10 Gy). Three patients underwent additional resection 14.5, 21, and 32 months after GKS. Results Of the 10 patients included in this study, 6 are seizure free (2 after they underwent additional surgery), 1 has a 50%–90% reduction in seizure frequency, 2 have a 50% reduction in seizure frequency, and 1 has observed no change in seizure frequency. Overall quality of life, based on data obtained from follow-up telephone conversations and/or surveys, improved in 9 patients and was due to improvements in seizure control (9 patients), short-term memory loss (3 patients), and behavioral symptoms (5 patients); in 1 patient, quality of life remains minimally affected. Incidences of morbidity were all temporary and included poikilothermia (1 patient), increased depression (1 patient), weight gain/increased appetite (2 patients), and anxiety (1 patient) after GKS. Conclusions Of the approximately 150 patients at Barrow Neurological Institute who have undergone treatment for HH, the authors have reserved GKS for treatment of small HHs located distal from radiosensitive structures in patients with high cognitive function and a stable clinical picture, which allows time for the effects of radiosurgery to occur without further deterioration. The lack of significant morbidity and the clinical outcomes achieved in this study demonstrated a low risk of GKS for HH with results comparable to those of previous series.

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Delev, Daniel, Karlijn Hakvoort, Alexander Grote, Georg Neuloh, Hans Clusmann, and Marec von Lehe. "Quality of life in elderly patients after surgery for drug-resistant epilepsy – The impact of seizure outcome, neurological deficits and anxiety." Epilepsy & Behavior 112 (November 2020): 107410. http://dx.doi.org/10.1016/j.yebeh.2020.107410.

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Ghatan, Saadi, Patricia McGoldrick, Christina Palmese, Maite La Vega-Talbott, Harriet Kang, Malgosia A. Kokoszka, Robert R. Goodman, and Steven M. Wolf. "Surgical management of medically refractory epilepsy due to early childhood stroke." Journal of Neurosurgery: Pediatrics 14, no. 1 (July 2014): 58–67. http://dx.doi.org/10.3171/2014.3.peds13440.

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Object The risk of developing epilepsy after perinatal stroke, hypoxic/ischemic injury, and intracerebral hemorrhage is significant, and seizures may become medically refractory in approximately 25% of these patients. Surgical management can be difficult due to multilobar or bilateral cortical injury, nonfocal or poorly lateralizing video electroencephalography (EEG) findings, and limited functional reserve. In this study the authors describe the surgical approaches, seizure outcomes, and complications in patients with epilepsy due to vascular etiologies in the perinatal period and early infancy. Methods The records were analyzed of 19 consecutive children and adults with medically refractory epilepsy and evidence of perinatal arterial branch occlusions, hypoxic/ischemic insult, or hemorrhagic strokes, who underwent surgery at the Comprehensive Epilepsy Center of Beth Israel Medical Center and St. Luke's-Roosevelt Hospital Center. Preoperative findings including MRI, video EEG, functional MRI, and neuropsychological testing were analyzed. The majority of patients underwent staged operations with invasive mapping, and all patients had either extra- or intraoperative functional mapping. Results In 7 patients with large porencephalic cysts due to major arterial branch occlusions, periinsular functional hemispherotomy was performed in 4 children, and in 3 patients, multilobar resections/disconnections were performed, with 1 patient undergoing additional resections 3 years after initial surgery due to recurrence of seizures. All of these patients have been seizure free (Engel Class IA) after a mean 4.5-year follow-up (range 15–77 months). Another 8 patients had intervascular border-zone ischemic infarcts and encephalomalacia, and in this cohort 2 hemispherotomies, 5 multilobar resections/disconnections, and 1 focal cortical resection were performed. Seven of these patients remain seizure free (Engel Class IA) after a mean 4.5-year follow-up (range 9–94 months), and 1 patient suffered a single seizure after 2.5 years of seizure freedom (Engel Class IB, 33-month follow-up). In the final 4 patients with vascular malformation-associated hemorrhagic or ischemic infarction in the perinatal period, a hemispherotomy was performed in 1 case, multilobar resections in 2 cases, and in 1 patient a partial temporal lobectomy was performed, followed 6 months later by a complete temporal and occipital lobectomy due to ongoing seizures. All of these patients have had seizure freedom (Engel Class IA) with a mean follow-up of 4.5 years (range 10–80 months). Complications included transient monoparesis or hemiparesis in 3 patients, transient mutism in 1 patient, infection in 1 patient, and a single case of permanent distal lower-extremity weakness. Transient mood disorders (depression and anxiety) were observed in 2 patients and required medical/therapeutic intervention. Conclusions Epilepsy surgery is effective in controlling medically intractable seizures after perinatal vascular insults. Seizure foci tend to be widespread and rarely limited to the area of injury identified through neuroimaging, with invasive monitoring directing multilobar resections in many cases. Long-term functional outcomes have been good in these patients, with significant improvements in independence, quality of life, cognitive development, and motor skills, despite transient postoperative monoparesis or hemiparesis and occasional mood disorders.

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Meldolesi, G. N., G. Di Gennaro, P. P. Quarato, V. Esposito, L. G. Grammaldo, P. Morosini, I. Cascavilla, and A. Picardi. "Changes in depression, anxiety, anger, and personality after resective surgery for drug-resistant temporal lobe epilepsy: A 2-year follow-up study." Epilepsy Research 77, no. 1 (October 2007): 22–30. http://dx.doi.org/10.1016/j.eplepsyres.2007.08.005.

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Phillips, Natalie L., Elysa Widjaja, and Mary Lou Smith. "Changes in caregiver depression, anxiety, and satisfaction with family relationships in families of children who did and did not undergo resective epilepsy surgery." Epilepsia 61, no. 10 (September 17, 2020): 2265–76. http://dx.doi.org/10.1111/epi.16672.

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Portuguez, Mirna Wetters, Danielle Irigoyen da Costa, Sabine Possa Marroni, Vanessa Pagliarini, and Karin Vieira. "Neuropsychological aspects of psychogenic nonepileptic seizures." Journal of Epilepsy and Clinical Neurophysiology 13, no. 4 suppl 1 (December 2007): 24–27. http://dx.doi.org/10.1590/s1676-26492007000500005.

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Psychogenic nonepileptic seizures (PNES) may be defined as paroxysmal changes in behavior that are similar to epileptic seizures but are not associated with quantifiable alterations in the electrical activity of the brain. At the Epilepsy Surgery Program (ESP) of the São Lucas Hospital at PUCRS (HSL-PUCRS), we studied 52 individuals (37 females and 15 males) with a diagnosis of PNES, associated (57%) or not (23%) with refractory epileptic seizures. We found emotional abuse (100%), physical abuse (80%), emotional neglect (80%), physical negligence (70%) and sexual abuse (30%), mood (40%) and anxiety disorders (50%), as the main psychological components in such population. Although the medical and psychosocial impact of PNES can be estimated as significant, the absence of specialized services for its treatment is striking. Multiple diagnostic and therapeutic procedures and the participation of a specialized multidisciplinary team â€“ where neuropsychology functions as a link between the mental processes/psychopathologies and the brain â€“ are required to ensure proper management of such cases.

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Nedelcuta, Ramona Mihaela, Vlad Dumitru Baleanu, Dragos Virgil Davitoiu, Tiberiu Stefanita Tenea Cojan, Cosmin Alexandru Ciora, and Gigi Calin. "Severe Anorexia in a Child with Arachnoid Cyst." Revista de Chimie 70, no. 10 (November 15, 2019): 3663–64. http://dx.doi.org/10.37358/rc.19.10.7618.

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The G.V. 5 year and 11 months old boy, accused anorexia, headache with left hemicrany with onset of about 2 weeks. The only conclusive anamnestic aspect is a cranio-cerebral trauma that occurred 2 months before the onset of the symptomatology. The child was completely clinical, laboratory, imaging examined. There were no somatic changes or biological parameters. In diagnostic imaging, CT reveals a temporoparietal arachnoid cyst without deformation of the ventricular system of 5.5/4.5 cm. The postoperative evolution of the case is unsatisfactory, 2 months after surgery the child develops iatrogenic epilepsy, behavioral disorders with anxiety, anxious syndrome and severe anorexia, refractory to treatment, as well as neurological manifestations - transient hemiparesis. We mention the issue of certainty indication for surgical intervention in a case of arachnoid cyst and the possibility of impairment and/or damage to the hypothalamus as control of hunger, satiety or damage at the level of synaptic transmission.

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Kiyokawa, Juri, Shinji Yamamoto, Yasuhiro Murota, Mariko Ishikawa, Hiroto Yamaoka, Satoshi Kaneko, Masataka Yoshimura, Shin Hirota, Motoki Inaji, and Taketoshi Maehara. "SURG-05. AN AWAKE SURGERY FOR A CHILD SUFFERING FROM EPILEPSY DUE TO DYSEMBRYPLASTIC NEUROEPITHELIAL TUMOR LOCATED IN THE LEFT PARIETAL LOBE." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii461—iii462. http://dx.doi.org/10.1093/neuonc/noaa222.802.

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Abstract BACKGROUND An awake surgery is a useful measure to remove tumors located close to eloquent areas of the brain to reduce surgical complications and maximize the resection. However, it has some disadvantages compared to surgeries under general anesthesia. Generally speaking, applying it to a child under 15 years-old (y/o) is hesitating because of anxiety, poor tolerance, failure to cooperate in tasks and so forth. Here, we present a case of a 13y/o girl who underwent an awake surgery due to dysembryplastic neuroepithelial tumor (DNT) located in the left parietal lobe. CASE PRESENTATION: She consulted our hospital for epileptic seizures. MRI showed a multilocular mass lesion in the left parietal lobe. The tumor was located in or close to eloquent areas. The epilepsy was refractory even with multiple antiepileptic drugs (AEDs). A Wada examination revealed that her speech area is on the left hemisphere. The operations were performed in two stages. Prior to the operations, we had several thought-out simulations in the operating room and ICU with her, her parents, and our staff including nurses and lab technicians. The first operation was to perform tumor biopsy and place intracranial electrodes. The histological diagnosis was DNT. Video electroencephalogram showed that the epileptogenic lesion was around the tumor. The second operation resulted in total tumor resection and reduction of paroxysmal epileptic spikes without major complications. She is seizure free for more than three years with two AEDs. CONCLUSION Careful preparations may enable an awake surgery even for a child under 15y/o.

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Jones, Jana E., Jacquelyn B. Blocher, and Daren C. Jackson. "Life Outcomes of Anterior Temporal Lobectomy." Neurosurgery 73, no. 6 (September 19, 2013): 1018–25. http://dx.doi.org/10.1227/neu.0000000000000145.

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Abstract BACKGROUND: At 3 time points, this study examined long-term psychosocial life outcomes of individuals who underwent anterior temporal lobectomy in comparison with individuals with temporal lobe epilepsy who were medically managed. OBJECTIVE: To examine seizure frequency, employment, driving, independent living, financial independence, mental health, and quality of life at each follow-up assessment, as well as predictors of outcomes. METHODS: All participants were diagnosed with medically intractable complex partial seizures of temporal lobe origin with or without secondary generalization. A structured clinical interview was used at all 3 time points. Information was obtained regarding seizure frequency, antiepilepsy medications, employment, driving status, financial assistance, and independent living. Additionally, questions regarding quality of life, satisfaction with surgery, and the presence of depression or anxiety were included. Participants were, on average, 17 years postsurgery. RESULTS: Surgery resulted in significantly improved and sustained seizure outcomes. At the first, second, and third follow-ups, 67%, 72%, and 67% of participants in the surgery group remained seizure-free in the year before the follow-up interview. At each follow-up, 97%, 84%, and 84% reported that they would undergo surgery again. Seizure freedom predicted driving outcomes at all 3 time points, but was not a significant predictor for employment, independent living, or financial independence. Psychosocial life outcomes in the surgical group were improved and maintained over time in comparison with the medically managed group. CONCLUSION: This systematic long-term investigation provides strong support for the positive impact of anterior temporal lobectomy on psychosocial life outcomes including driving, employment, independent living, and financial independence.

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Mori, Kentaro, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, et al. "Validation of effectiveness of keyhole clipping in nonfrail elderly patients with unruptured intracranial aneurysms." Journal of Neurosurgery 127, no. 6 (December 2017): 1307–14. http://dx.doi.org/10.3171/2016.9.jns161634.

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OBJECTIVEAdvanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients.METHODSKeyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs. There were 62 cases in the nonfrail elderly group (mean age 72.9 ± 2.6 years [± SD]) and 198 cases in the nonelderly group (mean age 59.5 ± 7.6 years). The authors evaluated mortality and morbidity (modified Rankin Scale score > 2 or Mini–Mental State Examination [MMSE] score < 24) at 3 months and 1 year after the operation, the general cognitive function by MMSE at 3 months and 1 year, anxiety and depression by the Beck Depression Inventory (BDI) and Hamilton Rating Scale for Depression (HAM-D) at 3 months, and radiological abnormalities and recurrence at 1 year.RESULTSBasic characteristics including comorbidities, frailty, and BDI and HAM-D scores were not significantly different between the 2 groups, whereas the MMSE score was slightly but significantly lower in the elderly group. Aneurysm location, largest diameter, type of keyhole surgery, neck clipping rate, and hospitalization period were not significantly different between the 2 groups. The incidence of chronic subdural hematoma was not significantly higher in the elderly group than in the nonelderly group (8.1% vs 4.5%, p = 0.332); rates of other complications including stroke and epilepsy were not significantly different. Lacunar infarction occurred in 3.2% of the elderly group and 3.0% of the nonelderly group. No patient in the elderly group required re-treatment or demonstrated recurrence of clipped aneurysms. The MMSE score at 3 months significantly improved in the nonelderly group but did not change in the elderly group. The BDI and HAM-D scores at 3 months were significantly improved in both groups. No patient died in either group. The morbidity at 3 months and 1 year in the elderly group (1.6% and 4.8%, respectively) was not significantly different from that in the nonelderly group (2.0% and 1.5%, respectively).CONCLUSIONSKeyhole clipping for nonfrail elderly patients with relatively small anterior circulation UIAs did not significantly increase the complication, mortality, or morbidity rate; hospitalization period; or aneurysm recurrence compared with nonelderly patients, and it was associated with improvement in anxiety and depression. Keyhole clipping to treat UIAs in the nonfrail elderly is an effective and long-lasting treatment.

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Labuschagne, Jason, Clover-Ann Lee, Denis Mutyaba, Tatenda Mbanje, and Cynthia Sibanda. "Awake Craniotomy in a Child: Assessment of Eligibility with a Simulated Theatre Experience." Case Reports in Anesthesiology 2020 (July 6, 2020): 1–5. http://dx.doi.org/10.1155/2020/6902075.

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Background. Awake craniotomy is a useful surgical approach to identify and preserve eloquent areas during tumour resection, during surgery for arteriovenous malformation resections and for resective epilepsy surgery. With decreasing age, a child’s ability to cooperate and mange an awake craniotomy becomes increasingly relevant. Preoperative screening is essential to identify the child who can undergo the procedure safely. Case Description. A 11-year-old female patient presented with a tumour in her right motor cortex, presumed to be a dysembryoplastic neuroepithelial tumour (DNET). We had concerns regarding the feasibility of performing awake surgery in this patient as psychological testing revealed easy distractibility and an inability to follow commands repetitively. We devised a simulated surgical experience to assess her ability to manage such a procedure. During the simulated theatre experience, attempts were made to replicate the actual theatre experience as closely as possible. The patient was dressed in theatre attire and brought into the theatre on a theatre trolley. She was then transferred onto the theatre bed and positioned in the same manner as she would be for the actual surgery. Her head was placed on a horseshoe headrest, and she was made to lie in a semilateral position, as required for the surgery. A blood pressure cuff, pulse oximeter, nasal cannula with oxygen flow, and calf pumps were applied. She was then draped precisely as she would have been for the procedure. Theatre lighting was set as it would be for the surgical case. The application of the monitoring devices, nasal cannula, and draping was meant not only to prepare her for the procedure but to induce a mild degree of stress such that we could assess the child’s coping skills and ability to undergo the procedure. The child performed well throughout the simulated run, and surgery was thus offered. An asleep-awake-asleep technique was planned and employed for surgical removal of the tumour. Cortical and subcortical mapping was used to identify the eloquent tissue. Throughout the procedure, the child was cooperative and anxiety free. Follow-up MRI revealed gross total removal of the lesion. Conclusion. A simulated theatre experience allowed us to accurately determine that this young patient, despite relative contraindications, was indeed eligible for awake surgery. We will continue to use this technique for all our young patients in assessing their eligibility for these procedures.

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Cojocaru, Eva Maria, Victorita Stefanescu, Ariela Elena Banu, and Aurel Nechita. "Medication Used in Neurologic Disorders Associated and/or Concomitant with Cerebral Arachnoid Cysts in Children." Revista de Chimie 69, no. 1 (February 15, 2018): 80–85. http://dx.doi.org/10.37358/rc.18.1.6048.

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Arachnoid cerebral cysts can create great anxiety to families of the affected child. In children prospective studies of arachnoid cerebral cyst series are focused on the surgical treatment and no medication associated tot this pathology was analysed until yet. We want to show how medication for neurological disorders found in children which have had also arachnoid cysts was used, and that not only surgery is the first line treatment in all types of arachnoid cysts.There are not extensive studies yet for the different contexts which are involving arachnoid cerebral cystsin children. This study was made for the first time in the cabinet of neurology from the Children Clinic Emergency Hospital Sfantul Ioan Galati in a 111 case series under clinic-imagistic surveillance and EEG between 2014-2017. A male predominance is seen as also a prevalence at the ages of 6-10 years of age and 2-5 years of age. Treatment were of different types due to the neurologic disorder which the children have had ( antiepileptic, neurotrophic, antiiinflammatory, nonsteroid and steroid and migraine treatment) after the international guidelines in use.The formulation of a diagnosis of epilepsy must be done with great responsibility because of many parioxistic nonepileptic events, where can exist associated arachnoid cysts, but we can have particulary family structures , because of the parents working places , so the waiting of the next paroxistic events and observing of the child is a wise attitude.But arachnoid cerebral cysts can be considered cerebral structural marker in some of the analysed cases.

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Sim, Sing Yang, and Ma’en Al-Mrayat. "Thyroid Paraganglioma- An Unusual Head and Neck Tumour." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A962. http://dx.doi.org/10.1210/jendso/bvab048.1966.

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Abstract Paragangliomas are neuroendocrine tumour originating from the neural crest-derived paraganglia with majority arising from the head and neck. (1)Thyroid paraganglioma are exceedingly rare neuroendocrine tumours accounting for <0.1% of thyroid malignancy (1) We present a 57 years old gentleman who was referred to ENT surgeon following discovery of a two month history of lump on his left neckIt has not changed in size and not caused any symptoms such as anxiety, sweats, palpitations, dizziness or unexplained headaches. He has a Past medical history of epilepsy following a Road traffic accident 28 years ago leaving him seizure prone. He has no family history of neuroendocrine tumours His ultrasound scan of his thyroid gland showed a 25 x 23 x 15mm lesion lying anteriorly within the left thyroid lobe. There are two highly reflective foci which could represent microcalcification. It was classified as U5 lesion He proceeded with fine needle aspiration which confirmed carcinoma of the left thyroid gland with no clear differentiation between follicular or papillary carcinoma. He undergone a total thyroidectomy and left central level VI lymph node dissection His histology confirmed a thyroid paraganglioma staining strongly positive for neuroendocrine markers (Synaptophysin and chromogranin) while S-100 shows positivity in the sustentacular cells. He was referred for genetic testing which demonstrate no evidence of mutation in FH, SDHAF2, SDHB/C/D, RET, MAX, TMEM127 and VHL gene. He was commenced on levothyroxine replacement at a dose of 150micrograms OD. His urine metanephrines is 178.1pmol/L (0-510), urine normetanephrines 192.9pmol/L (0-1180) and 3-methoxytyramine <75pmol/ L (0-180) (all normal). His MRI neck revealed no synchronous tumour. He continues to be followed up under our endocrine clinic. Conclusion: Due to the rarity of these tumours, their natural history is mostly unknown. Nevertheless, postoperative surveillance should include plasma or urinary metanephrines and ultrasonography. References: 1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824793/

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"Epilepsy Surgery Reduces Depression and Anxiety." Chronic Illness 2, no. 1 (March 2006): 4. http://dx.doi.org/10.1177/17423953060020010404.

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Bakhtiar, Yuriz, Surya Pratama Brilliantika, Jacob Bunyamin, Muhammad Thohar Arifin, Hardian Hardian, Aris Catur Bintoro, and Zainal Muttaqin. "Postoperative Evaluation of the Quality of Life, Depression, and Anxiety of Temporal Lobe Epilepsy Cohort: A Single Institute Experience in Indonesia." Frontiers in Neurology 12 (September 14, 2021). http://dx.doi.org/10.3389/fneur.2021.708064.

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Background: Besides seizure control, quality of life (QoL) should be considered as an equally important outcome for epilepsy surgery service providers. The paucity of QoL reports from developing countries has enlarged the representation gap between wealthy countries and countries with fewer resources. In this study, we evaluated postoperative QoL in the Indonesian drug-resistant epilepsy cohort where the epilepsy surgery service faces limited resource availability.Methods: We evaluated the QoL in patients with temporal lobe epilepsy who underwent surgery in our epilepsy surgery center in Semarang, Indonesia, from 2001 until 2015. The follow–up period started in 2018 through 2019. Postoperative QoL, depression, and anxiety were evaluated with self-reporting questionnaires including the Quality of Life in Epilepsy Inventory-31, Beck Depression Inventory-II, and Zung Self-Rating Anxiety Scales.Results: Forty returned questionnaires were included in the analysis (male 25, 62.5%; mean age 27.6 ± 9.05 years). The seizure-free cohort (n = 22, 55.0%) reported higher scores in most QoL dimensions particularly adjustment, overall QoL, and seizure worry compared to those with persistent seizures. The overall QoL level was correlated with seizure freedom and surgery type. QoL dimensions were negatively correlated with anxiety and depression levels.Conclusions: Postoperative seizure freedom was a major factor of postoperative QoL level. Besides seizure freedom, anxiety and depression levels were also negatively correlated with QoL levels in the Indonesian population.

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Patel, S., M. Clancy, H. Barry, N. Quigley, M. Clarke, M. Cannon, N. Delanty, K. C. Murphy, and D. Cotter. "Psychiatric and psychosocial morbidity 1 year after epilepsy surgery." Irish Journal of Psychological Medicine, November 24, 2020, 1–8. http://dx.doi.org/10.1017/ipm.2020.114.

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Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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Mula, Marco, Andres M. Kanner, Nathalie Jette, and Josemir W. Sander. "Psychiatric comorbidities in people with epilepsy." Neurology: Clinical Practice, May 29, 2020, 10.1212/CPJ.0000000000000874. http://dx.doi.org/10.1212/cpj.0000000000000874.

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ABSTRACTPurposeof review: To review the latest evidence concerning the epidemiology, clinical implications and management of psychiatric disorders in epilepsy.Recent findings:People with epilepsy have a 2 to 5 times increased risk of developing any psychiatric disorder and 1 in 3 patients with epilepsy have a lifetime psychiatric diagnosis. Psychiatric comorbidities represent a poor prognostic marker as they have been associated with a poor response to treatment (drugs and surgery), increased morbidity and mortality. Validated screening instruments are available for mood and anxiety disorders in adults as well as attention deficit hyperactivity disorder in children with epilepsy.Summary:All patients with epilepsy should be routinely screened for psychiatric disorder at the onset and at least once a year. Patients with epilepsy and their relatives should be informed of the risk of mental health problems and the implications.

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ELAhwal, Shereen Ahmed, Yasser Abo Elfotoh El-Heneedy, Wafik Said Bahnasy, Reham Abdel Rahman Amer, and Khaled Hussein Rashed. "The interictal activities load and cognitive performance of children with typical absence epilepsy." Egyptian Journal of Neurology, Psychiatry and Neurosurgery 57, no. 1 (May 10, 2021). http://dx.doi.org/10.1186/s41983-021-00299-z.

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Abstract Background The description of childhood absence epilepsy (CAE) a benign self-limited generalized epilepsy has become a matter of debate. The objectives of this work were to evaluate the existence of psychiatric and cognitive impairments among patients with typical CAE and to correlate their possible relation to seizure frequency, duration of epilepsy, IISL, and valproate therapy. Methods The study was conducted on 19 typical CAE patients receiving valproate therapy, 11 newly diagnosed CAE patients not receiving AEDs, and 30 healthy control subjects (HCS). Participants were subjected to medical history taking, EEG monitoring, child behavior checklist (CBCL), Stanford Binet Intelligence Scale 5th edition, and computerized psychometric tests that assess cognitive domains and executive functions. Results The study revealed a high rate of cognitive and psychiatric dysfunctions in CAE patients. 53.3% of patients had psychiatric problems versus 16.6% in HCS. Attention deficit hyperactive disorder (ADHD) (26.6%), anxiety (16.6%), and depression (6.6%) were the most common psychiatric disorders in the patient group. Withdrawn/depressed symptoms, thought problems, social problems, and attention problems in CAE patients were significantly increased compared to HCS. At the same time, CAE patients perform worse in cognitive scales than HCS with comparable intelligent quotient (IQ) scores. Conclusion Cognitive and psychiatric impairments in typical CAE patients appear multifactorial in origin with epilepsy-related factors including the duration of epilepsy and interictal spike load (IISL).

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Tang, Weiting, Xinghui He, Li Feng, Dingyang Liu, Zhuanyi Yang, Junmei Zhang, Bo Xiao, and Zhiquan Yang. "The Role of Hippocampal Neurogenesis in ANT-DBS for LiCl-Pilocarpine-Induced Epileptic Rats." Stereotactic and Functional Neurosurgery, December 10, 2020, 1–10. http://dx.doi.org/10.1159/000509314.

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Purpose: Abnormal neurogenesis in the hippocampus after status epilepticus (SE) has been suggested as a key pathogeny of temporal lobe epilepsy. This study aimed to investigate the effect of deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) on hippocampal neurogenesis in LiCl-pilocarpine-induced epileptic rats and to analyze its relationship with postoperative spontaneous recurrent seizures (SRS) and anxiety. Method: SE was induced by a systemic LiCl-pilocarpine injection in adult male rats. Rats in the DBS group underwent ANT-DBS immediately after successful SE induction. SRS was only recorded during the chronic stage. An elevated plus maze was used to evaluate the level of anxiety in rats 7, 28, and 60 days after SE onset. After the elevated plus-maze experiment, rats were sacrificed under anesthesia in order to evaluate hippocampal neurogenesis. Doublecortin (DCX) was used as a marker for neurogenesis. Results: During the chronic stage, SRS in rats in the DBS group were significantly decreased. The level of anxiety was increased significantly in rats in the DBS group 28 days after SE, while no significant differences in anxiety levels were found 7 and 60 days after SE. The number of DCX-positive cells in the hippocampus was significantly increased 7 days after SE and was significantly decreased 60 days after SE in all rats in which SE was induced. However, the number of DCX-positive cells in the DBS group was significantly lower than that in the other groups 28 days after SE. Conclusions: ANT-DBS may suppress SRS and increase the postoperative anxiety of epileptic rats by influencing hippocampal neurogenesis.

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"Severe Anorexia in a Child with Arachnoid Cyst." Revista de Chimie 70, no. 10 (November 14, 2019): 3663–64. http://dx.doi.org/10.37358/rc.19.10.3663.

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The G.V. 5 year and 11 months old boy, accused anorexia, headache with left hemicrany with onset of about 2 weeks. The only conclusive anamnestic aspect is a cranio-cerebral trauma that occurred 2 months before the onset of the symptomatology. The child was completely clinical, laboratory, imaging examined. There were no somatic changes or biological parameters. In diagnostic imaging, CT reveals a temporoparietal arachnoid cyst without deformation of the ventricular system of 5.5/4.5 cm. The postoperative evolution of the case is unsatisfactory, 2 months after surgery the child develops iatrogenic epilepsy, behavioral disorders with anxiety, anxious syndrome and severe anorexia, refractory to treatment, as well as neurological manifestations - transient hemiparesis. We mention the issue of certainty indication for surgical intervention in a case of arachnoid cyst and the possibility of impairment and/or damage to the hypothalamus as control of hunger, satiety or damage at the level of synaptic transmission. Keywords: anorexia, arachnoid cyst, ventricular system

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Piskorska, Natalia, and Andrzej Silczuk. "Atypical benzodiazepine misuse and withdrawal in patient with epilepsy: a case report." Egyptian Journal of Neurology, Psychiatry and Neurosurgery 56, no. 1 (November 26, 2020). http://dx.doi.org/10.1186/s41983-020-00248-2.

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Abstract Background Benzodiazepines (BDZ) are a class of psychoactive drugs that have been widely used for the treatment of many medical conditions. In this paper, a case of an atypical pattern of diazepam dependence in a patient with epilepsy is presented. The article may be an interesting proposition for rational management in the treatment of benzodiazepine dependence in a patient with non-withdrawal and withdrawal seizures. Detoxification is used then to optimize neurological treatment. Case presentation A 52-year-old Caucasian male, diagnosed with epilepsy with partial complex, and rarely tonic-clonic seizures and benzodiazepine (diazepam) misuse, was admitted to a detoxification unit specialized to treat substance dependence. This patient presented an atypical schedule of substance misuse with a weekly dose of 40 to 45 mg of diazepam, taken once a week, every Saturday. The patient reported having a group of symptoms that usually preceded generalized seizures that were described as the “aura” manifesting as confusion, derealisation, anxiety, and difficulties in speaking. First Saturday after admission to the hospital, the first aura experience was reported, while diazepam level in serum was higher than usual, which was supporting also strong psychological background for withdrawal. On weekend days, 3 weeks after admission, when the patient was receiving 3 mg of diazepam daily, he developed a severe “aura.” The EEG showed no seizure activity. Two weeks later (again Friday to Saturday), the patient reported the occurrence of aura, the EEG recording showed paroxysmal discharges, generalized multiple spikes associated with slow waves, lasting about 30 s, accompanied by eyelid myoclonia and disturbed consciousness. A week later another aura developed that resolved spontaneously without a seizure. Twelve days later, diazepam was completely removed; the elimination of serum benzodiazepines took place. The patient did not report aura until the end of the stay and he was dismissed 5 weeks later. Conclusions The differential diagnosis of an aura can be challenging. Carefully proceed serum monitored elimination of benzodiazepines in epileptic patients may serve in safety benefits and helps to achieve detoxification goals. Hence, it is important to prevent, recognize, and treat benzodiazepine dependence in every patient and may improve epilepsy treatment outcome.

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Brandalise, Maria Helena, and George Barbosa. "Depressive and Anxiety Symptoms Exert Negative Impact on Resilience to Stressful Events in Patients with Refractory Temporal Lobe Epilepsy with Late Seizure Recurrence after Surgery." Journal of Psychology & Psychotherapy 6, no. 3 (2016). http://dx.doi.org/10.4172/2161-0487.1000269.

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Rydén, Isabelle, Erik Thurin, Louise Carstam, Anja Smits, Sasha Gulati, Roger Henriksson, Øyvind Salvesen, and Asgeir Store Jakola. "Psychotropic and anti-epileptic drug use, before and after surgery, among patients with low-grade glioma: a nationwide matched cohort study." BMC Cancer 21, no. 1 (March 8, 2021). http://dx.doi.org/10.1186/s12885-021-07939-w.

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Abstract Background Low-grade glioma (LGG) is a relatively rare type of brain tumour. The use of antidepressant, sedative and anti-epileptic drugs can reflect the burden of the disease. While epilepsy is well-described in patients with LGG, less is known about depression and anxiety. Methods We used nationwide registers to study the use (dispense) of antidepressants, sedatives, and anti-epileptic drugs (AEDs) before and after histopathological LGG diagnosis (WHO grade II). A total of 485 adult patients with a first-time diagnosis and a matched control cohort (n = 2412) were included. Patterns of use were analysed from one year prior to until one year following index date (date of surgery). Logistic regression analysis identified predictors for postoperative use. Results At one year before index date, patients were dispensed AEDs 4 times more than controls, while antidepressants and sedatives were similar. Sedatives and AED peaked shortly after index date at 25 and 69%, respectively. AEDs then stabilized while sedatives decreased rapidly. For antidepressants, a delayed increase was seen after index date, stabilizing at 12%. At one year after index date, the use of antidepressants, sedatives, and AEDs among patients was 2, 3, and 26 times higher, respectively, compared to controls. Predictor for use of AEDs and sedatives at one year following index was previous use and/or a related diagnosis. Female sex and later index year were additional predictors for antidepressants. Conclusions Use of antidepressants, sedatives and AEDs is elevated following diagnosis of LGG. Antidepressants were more commonly dispensed to female patients and in recent years.

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Journal articles on the topic 'Surgery, epilepsy, anxiety'

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