Foong J, Flugel D
Department of Neuropsychiatry, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Epilepsy Res. 2007 Jul;75(2-3):84-96. doi: 10.1016/j.eplepsyres.2007.05.005. Epub 2007 Jun 28.
In recent years, surgery has become a treatment option for some patients with intractable epilepsy, particularly those with temporal lobe epilepsy. Psychiatric disturbances may complicate the postsurgical outcome in some patients and de novo psychiatric symptoms have been reported. In many but not all epilepsy surgical centres, a psychiatric assessment is included as part of the presurgical evaluation of potential candidates for surgery. This review indicates that affective disorders, namely, depression and anxiety, and psychosis are the most frequently reported postsurgical psychiatric disturbances. Whilst there are no absolute psychiatric contraindications to surgery, certain pre-existing psychiatric conditions may need careful consideration as there may be a risk of postsurgical psychiatric complications. Routine pre- and postsurgical psychiatric evaluations in patients undergoing epilepsy surgery are recommended. Clinicians involved in the care of surgical candidates should be aware of the possible psychiatric complications following surgery and ensure that the psychiatric risks are discussed with the patient and family.
近年来，手术已成为一些难治性癫痫患者的治疗选择，尤其是颞叶癫痫患者。精神障碍可能会使一些患者的术后结果复杂化，并且已有新发精神症状的报道。在许多（但并非所有）癫痫手术中心，精神病学评估被纳入潜在手术候选人术前评估的一部分。本综述表明，情感障碍，即抑郁和焦虑，以及精神病是最常报道的术后精神障碍。虽然手术没有绝对的精神科禁忌证，但某些已存在的精神状况可能需要仔细考虑，因为可能存在术后精神科并发症的风险。建议对接受癫痫手术的患者进行常规的术前和术后精神病学评估。参与手术候选人护理的临床医生应意识到手术后可能出现的精神科并发症，并确保与患者及其家属讨论精神科风险。
