Neuropsychiatric Unit, Neurology Division, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Seizure. 2010 Oct;19(8):479-84. doi: 10.1016/j.seizure.2010.07.004. Epub 2010 Aug 13.
To evaluate the frequency and intensity of psychiatric disorders in a group of temporal lobe epilepsy (TLE) patients from a tertiary-care center.
Clinical and sociodemographic data of 73 patients were collected and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured clinical interview (MINI-PLUS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Brief Psychiatric Rating Scale (BPRS).
Patients with TLE showed a high frequency of lifetime psychiatric disorders (70%), the most frequent being mood disorders (49.3%). At assessment, 27.4% of the patients were depressed and 9.6% met criteria for bipolar disorder. Nevertheless, depression had not been properly diagnosed nor treated. Anxiety disorders were also frequent (42.5%), mainly generalized anxiety disorder (GAD) (21.9%). Obsessive compulsive disorder (OCD) was present in 11.0% and psychotic disorders in 5.5% of the sample. Patients with left mesial temporal sclerosis (LMTS) exhibited more psychopathologic features, mainly anxiety disorders (p=0.006), and scored higher on HAM-A and HAM-D (p<0.05 in both).
TLE is related to a high frequency of psychiatric disorders, such as anxiety and depression, which are usually underdiagnosed and undertreated. Damage to the left mesial temporal lobe, seen in LMTS, seems to be an important pathogenic lesion linked to a broad range of psychopathological features in TLE, mainly anxiety disorders. The present study prompts discussion on the recognition of the common psychiatric disorders in TLE, especially on the Brazilian setting.
评估一家三级护理中心的颞叶癫痫（TLE）患者群体中精神障碍的频率和强度。
收集了 73 名患者的临床和社会人口统计学数据，并使用以下工具进行神经精神病学评估：简易精神状态检查（MMSE）、结构临床访谈（MINI-PLUS）、汉密尔顿焦虑量表（HAM-A）、汉密尔顿抑郁量表（HAM-D）、简明精神病评定量表（BPRS）。
TLE 患者有很高的终生精神障碍发生率（70%），最常见的是情绪障碍（49.3%）。在评估时，27.4%的患者抑郁，9.6%符合双相情感障碍的标准。然而，抑郁并没有得到适当的诊断和治疗。焦虑障碍也很常见（42.5%），主要是广泛性焦虑障碍（GAD）（21.9%）。强迫症（OCD）为 11.0%，精神分裂症为 5.5%。左侧内侧颞叶硬化（LMTS）患者表现出更多的精神病理特征，主要是焦虑障碍（p=0.006），HAM-A 和 HAM-D 评分较高（p<0.05）。
TLE 与高频率的精神障碍有关，如焦虑和抑郁，这些障碍通常被漏诊和治疗不足。LMTS 中所见的左侧内侧颞叶损伤似乎是与 TLE 中广泛的精神病理特征相关的重要致病病变，主要是焦虑障碍。本研究促使人们对 TLE 中常见精神障碍的认识进行讨论，特别是在巴西环境下。
