Psychiatric symptoms following anterior temporal lobectomy

Abstract

Psychiatric manifestations following temporal lobectomy in twenty two patients were examined. Three patients experienced de novo psychosis after right temporal lobectomy. Depression occured within three months after the temporal lobectomy and lead to suicide attempt in extreme cases. Preoperative agression and hostility were ameliorated. Although most of the postoperative psychiatric symptoms disappeared within a year following surgery, abnormal mental states continued to be present for more than twelve months in two cases. The comparison between the group of patients with postoperative abnormal mental states (n = 10) and that without (n = 12) revealed abundance of ictal fear as well as dreamy state and predominance of the history of presurgical psychotic episode in the former. In view of the postoperative psychosis described in the literature, the current study suggested that postoperative psychiatric manifestations could not be explained fully by the psychogenic theory, and that not only neurological and neuropsychological but also psychiatric assessments were essential following temporal lobectomy. Most of the postoperative psychotic episodes could be shortened or aborted by an appropriate medical therapy. Recognition of them as early as possible is all the more important for it.