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Previous work has identified elevated prevalence rates for psychiatric
disorders in individuals with medically refractory focal epilepsy,
particularly temporal lobe epilepsy. Many studies were undertaken before
the advent of video electroencephalogram monitoring (VEM) and magnetic
resonance imaging (MRI).
To investigate which characteristics of the focal epilepsy syndromes are
associated with the presence of depression or psychosis.
Three hundred and nineteen individuals with focal epilepsy admitted for
VEM were seen over an 11-year period. The lifetime history of depression
and psychosis, epileptic site, laterality and type of lesion were
determined by clinical assessment, VEM and MRI scan.
There was a significant association between the prevalence of depressive
symptoms and non-lesional focal epilepsy. There were no significant
differences in prevalence of neuropsychiatric disorders between the
groups with temporal lobe epilepsy and those with extratemporal lobe
These findings contrast with previous findings in smaller cohorts. The
association between non-lesional focal epilepsy and depression may be due
to the effects of a more diffuse epileptogenic area.
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