A presentation from Gowers Award-winning researcher Rebecca Cleary (UK) underscores the importance of early surgical intervention. In a session at the 10th European Congress on Epileptology, Ms Cleary discussed its role in preventing the development of long-term psychiatric problems in people with epilepsy.
Ms Cleary presented the findings of a small study exploring postictal psychosis (PIP) in people with temporal lobe epilepsy. Her study looked specifically at people with a history of PIP who then had surgical procedures to remove brain tissue. Her analysis assessed whether such people were at a higher risk of developing psychiatric problems after their surgeries.
Those who had only had one PIP episode before their surgery did not show an increased risk of developing a 'de novo' psychiatric condition afterwards. However, research findings suggest that PIP does represent a risk factor for post-surgical psychiatric conditions - if a person has experienced two or more PIP episodes before their surgery. Those people demonstrated a 71 per cent chance of developing post-surgical psychopathologies.
Interestingly, there was a clear association of those people at risk of repeated PIP episodes and a documented family history of psychiatric illness. In translating her research into clinical practice, Ms Cleary stressed the importance of pre-surgical counselling. At this point, clinicians must check for any family history of psychiatric problems to properly inform the patient of any increased risks. She also emphasised that early referral for pre-surgical assessment is key. This may also avoid a second PIP episode - which appears to be the main risk factor for post-surgical psychopathologies.