Document Detail


Psychosis after resection of ganglioglioma or DNET: evidence for an association.
MedLine Citation:
PMID:  9924906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: David Taylor and Murray Falconer suggested that some patients may develop a psychotic illness after resection of a ganglioglioma that led to intractable seizures. They implied that the mechanism of this association remained unclear. This concept is currently not universally accepted (M. Trimble, personal communication). METHODS: We studied six children or young adults from four centers who developed psychosis after resection of a ganglioglioma or dysembryoplastic neuroepithelioma (DNET). RESULTS: All patients were operated on because of intractable epilepsy. The lesions involved mainly the temporal lobe. Patients had good outcomes for seizure control. In none of the six was potentially psychogenic medication used nor were the psychotic symptoms postictal in nature. The psychosis was schizophreniform with paranoid features and prominent depressive symptoms. Although some behavioral abnormalities were described preoperatively, none had been psychotic before operation. This type of psychotic reaction was not encountered in the four centers in a comparable period after resection of other types of lesions. This complication is rare; it occurred in only one of 39 patients who had such a lesion resected. CONCLUSIONS: Psychotic illness may rarely occur after resection of a ganglioglioma or DNET for treatment of intractable epilepsy. This does not seem to occur after removal of other types of lesions. Because the patients had good outcomes for seizures, the mechanism may be related to "forced normalization." The original observations of Taylor and Falconer are confirmed by this study; the reasons for the selective occurrence, however, remain speculative.
Authors:
L F Andermann; G Savard; H J Meencke; R McLachlan; S Moshé; F Andermann
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Publication Detail:
Type:  Case Reports; Journal Article; Multicenter Study    
Journal Detail:
Title:  Epilepsia     Volume:  40     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-02-04     Completed Date:  1999-02-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  83-7     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brain Neoplasms / surgery*
Child
Depressive Disorder / etiology
Epilepsy, Temporal Lobe / etiology,  surgery*
Female
Ganglioglioma / complications,  surgery*
Humans
Male
Neuroectodermal Tumors, Primitive, Peripheral / complications,  surgery*
Paranoid Disorders / etiology
Postoperative Complications / etiology*
Psychotic Disorders / etiology*
Temporal Lobe / surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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