Artículos de revistas
Pre-surgical mood disorders associated to worse post-surgical seizure outcome in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis
Fecha
2012-03-01Registro en:
Journal of Epilepsy and Clinical Neurophysiology. Liga Brasileira de Epilepsia (LBE), v. 18, n. 1, p. 21-25, 2012.
1676-2649
S1676-26492012000100006.pdf
S1676-26492012000100006
10.1590/S1676-26492012000100006
Autor
Araujo Filho, Gerardo Maria de
Gomes, Francinaldo Lobato
Mazetto, Lenon
Marinho, Murilo Martinez
Tavares, Igor Melo
Caboclo, Luís Otávio Sales Ferreira
Yacubian, Elza Márcia Targas
Centeno, Ricardo Silva
Institución
Resumen
OBJECTIVES: This study aims at verifying the impact of pre-surgical PD on seizure outcome in patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS). METHODS: After previous consent, retrospective data from 115 surgically treated (corticoamygdalohyppocampectomy) TLE-MTS patients (65 females; 56.5%) were analyzed. Psychiatric evaluations were performed through DSM-IV criteria. Engel IA was established as a favorable prognosis. RESULTS: Forty-five patients (41.6%) were classified as Engel IA, while 47 (40.8%) presented pre-surgical PD. Depression (OR=5.11; p=0.004) appeared as a risk factor associated to a non-favorable seizure outcome. CONCLUSION: In patients with refractory TLE-MTS, the presence of depression predicts an unfavorable outcome. OBJETIVO: No presente trabalho avaliamos o impacto da presença de transtorno psiquiátrico pré-cirúrgico sobre o prognóstico cirúrgico em pacientes com epilepsia do lobo temporal e esclerose mesial temporal (ELT-EMT). METODOLOGIA: Analisamos, retrospectivamente, os dados de 115 pacientes com ELT-EMT (65 mulheres, 56,5%) tratados cirurgicamente (corticoamigdalohipocampectomia). As avaliações psiquiátricas foram feitas de acordo com os critérios DSM-IV. O prognóstico favorável foi definido como ausência de crises desde a cirurgia (Engel IA). RESULTADOS: Dos 115 pacientes tratados, 45 (42,6%) tiveram prognóstico favorável e 47 (40,8%) apresentavam transtorno psiquiátrico pré-operatório. A presença de depressão (OR=5,11; p=0,004) foi associada ao prognóstico cirúrgico desfavorável. CONCLUSÃO: A presença de depressão durante a avaliação psiquiátrica pré-operatória é um fator preditivo de prognóstico desfavorável em pacientes com ELT-EMT.
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