Schizophrenia-like psychosis arising de novo following a temporal lobectomy: timing and risk factors

Shaw, P.; Mellers, J.; Henderson, M.; Polkey, C.; David, A. S.; Toone, B. K.
July 2004
Journal of Neurology, Neurosurgery & Psychiatry;Jul2004, Vol. 75 Issue 7, p1003
Academic Journal
journal article
Objectives: To clarify risk factors for the development of schizophrenia-like psychotic disorders following temporal lobectomy, and to explore the possibility that the early postoperative period is a time of high risk for the onset of such chronic psychotic disorders.Methods: Patients who developed schizophrenia-like psychosis were identified from a series of 320 patients who had a temporal lobectomy for medically intractable epilepsy. The relationship of their disorders to both the operation and subsequent seizure activity was examined. Using a retrospective case-control design, risk factors for the development of schizophrenia-like psychosis were established.Results: Eleven patients who developed schizophrenia-like psychosis postoperatively were identified and compared with 33 control subjects who remained free of psychosis postoperatively. The onset of de novo psychotic symptoms was typically in the first year following the operation. No clear relationship between postoperative seizure activity and fluctuations in psychotic symptoms emerged. Compared with the controls, patients who become psychotic had more preoperative bilateral electroencephalogram (EEG) abnormalities, pathologies other than mesial temporal sclerosis in the excised lobe and a smaller amygdala on the unoperated side.Conclusions: Temporal lobectomy for medically intractable epilepsy may precipitate a schizophrenia-like psychosis. Patients with bilateral functional and structural abnormalities, particularly of the amygdala, may be at particular risk for the development of such psychoses.


Related Articles

  • Epilepsy surgery in India. Radhakrishnan, Kurupath // Neurology India;Jan/Feb2009, Vol. 57 Issue 1, p4 

    This review traces the evolution of epilepsy surgery in India from the beginning to the present state. During the last one and half decades, surgical treatment of epilepsies has made resurgence in this country and at present a few centers have very active and sustained epilepsy surgery programs....

  • Frontal lobe epilepsy: diagnosis and surgical treatment. Wetjen, Nicholas M.; Cohen-Gadol, Aaron A.; Maher, Cormac O.; Marsh, W. Richard; Meyer, Fredric B.; Cascino, Gregory D. // Neurosurgical Review;Jun2002, Vol. 25 Issue 3, p119 

    Frontal lobe epilepsy has been better understood during the past two decades with the advent of technologies with improved localizing capabilities. Major technological advances in the ability to delineate structural and functional brain regions have led to a resurgence of interest in epilepsy...

  • Medical and surgical treatment of epilepsy. Strupp, Michael // Journal of Neurology;Feb2007, Vol. 254 Issue 2, p268 

    The article presents a study on the medical and surgical treatment of epilepsy. The researchers explore the comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsy. An evaluation of the clinical examination of the effectiveness of the treatment that changes...

  • Memory for Words and Memory for Numbers. Serafetinides, E. A. // Journal of Learning Disabilities;Mar1969, Vol. 2 Issue 3, p142 

    Two cases are presented in which an anterior temporal lobectomy for epilepsy, performed on the dominant side for speech, showed side effects in the form of memory impairment for words but not for numbers.

  • Frontal lobe epilepsy: diagnosis and surgical treatment. Grunert, Peter // Neurosurgical Review;Jun2002, Vol. 25 Issue 3, p140 

    Comments on surgical management of frontal lobe epilepsy. Identification of frontal lobectomy technique and subpial cortical transection as less destructive alternative in surgical interventions; Factors qualifying patients for the epilepsy surgery; Sufficiency of lesionectomy for epilepsy surgery.

  • Can Magnetoencephalography Aid Epilepsy Surgery? Knowlton, Robert C. // Epilepsy Currents;Jan2008, Vol. 8 Issue 1, p1 

    Magnetoencephalography (MEG) has a long history of development for the application of epilepsy. Technical and clinical validation of spike source estimation has been demonstrated in most partial epilepsies. The question that needs to be clarified concerns clinical value: Do identification and...

  • Development of malignant glioma 15 months after anterior temporal lobectomy in a patient with temporal lobe epilepsy. Morino, M.; Ichinose, T.; Terakawa, Y.; Haba, T.; Wakasa, K.; Ohata, K.; Hara, M. // Acta Neurochirurgica;Jan2004, Vol. 146 Issue 1, p59 

    Summary We report a 36-year-old woman, who had previously undergone anterior temporal lobectomy for intractable temporal lobe seizures; fifteen months later, magnetic resonance (MR) images showed a space-occupying lesion in the temporal lobectomy cavity. After a second operation, a...

  • Selection of patients with chronic drug-resistant epilepsy for resective surgery: 5 years' experience. Polkey, C. E. // Journal of the Royal Society of Medicine;Aug1981, Vol. 74 Issue 8, p574 

    Selection criteria are the key to success in resective surgery for intractable epilepsy. Using such criteria about 50% of patients admitted for assessment are considered unsuitable, half of these for neurophysiological reasons or because there is evidence of more than one area of structural...

  • Epilepsy.  // Current Medical Literature: Neurology;2010, Vol. 26 Issue 2, p61 

    The article discusses clinical reviews on epilepsy. The study "Functional and Cognitive Outcome in Prolonged Refractory Status Epilepticus" concludes that prolonged duration of status epilepticus alone should not be considered as a reason to discontinue treatment of such. The article "Recurrent...


Read the Article


Sign out of this library

Other Topics