Kids' Mood and Behavior After Epilepsy Surgery

Epilepsy surgery impact on mood and behavior depended on surgical and brain area

(RxWiki News) Children with epilepsy are at risk for behavior problems, depression and anxiety. And past studies have shown that mood and behavior may change in kids after epilepsy surgery.

A recent study set out to see how much these children's moods and behaviors actually changed.

This study found that epilepsy surgery impacted kids’ mood and behavior positively. But the outcomes differed based on the surgery site and brain hemisphere.

"Discuss changes in your child's mood or behavior with a pediatrician."

Epilepsy is a medical condition that produces seizures. It’s the third most common neurological disorder (after Alzheimer’s disease and stroke). It affects 3 million people in the United States and 50 million people globally.

This recent study was led by Elizabeth Andresen, PhD, of the Cleveland Clinic.

A total of 101 pediatric epilepsy surgery patients were studied. The researchers looked at how the surgical site (temporal and front parts of the brain) and brain’s hemisphere (left and right) impacted the mood, anxiety and behavior of 5- to 16-year-old children after epilepsy surgery.

“I talk to all my pediatric epilepsy patients and families about mood and behavior from the first visit/seizure. Children and anyone with seizures are at a risk of mood and behavior changes,” says Ryan Coates, MD, Assistant Professor of Neurology and Pediatrics, Loyola University Chicago Stritch School of Medicine/Loyola University Medical Center. “The two most common changes are becoming depressed or anxious, with both disorders being closely related,” he continued.

Of the patients, 38 had left temporal lobe epilepsy (TLE) and 26 had right TLE. Another 17 had left frontal lobe epilepsy (FLE) and 20 had right FLE.

The kids in this study and their primary caregivers filled out standardized questionnaires before surgery and about 10 months after surgery to assess behavioral and emotional function.

The study found that patients with FLE had more symptoms of anxiety and withdrawal before surgery than the TLE group. But the FLE group showed significant anxiety and mood improvement after surgery, with levels comparable to or below those of patients with TLE.

Overall, a notable number of patients showed improvement in mood and anxiety after surgery. Overall, 21 percent of patients (15 percent TLE and 33 percent FLE) had improved depression symptoms after surgery, and 38 percent had improvement in anxiety symptoms after surgery (26 percent TLE and 45 percent FLE).

Dr. Coates continued to comment that as a result of this study, he will reinforce to his epilepsy patients about the potential of these mood and behavior changes. He said that in his patients who were candidates for surgery (especially in his FLE patients), he would discuss the potential benefits of surgery on mood and behavior symptoms.

“We were pleased to discover that children generally experience improvements in mood and behavior following epilepsy surgery,” said Dr. Andresen in a press release from the American Epilepsy Society.

“While children with FLE had greater symptoms of depression and anxiety before surgery than children with TLE, these symptoms improved significantly following surgery to levels comparable to or below the temporal lobe group. Interestingly, these relationships were most apparent in children who underwent left-sided surgeries,” she said.

This study was reported at the American Epilepsy Society meeting in December and conducted by researchers from the Cleveland Clinic and University of Pittsburgh. This research has yet to be published in a peer-reviewed journal. As such, these findings should be interpreted with caution.

Review Date: 
November 22, 2013