The effects of temporal lobectomy in epileptic patients with psychosis

Abstract

The relationship in the same patient of epilepsy and psychosis is little understood. Although patients with temporal lobe epilepsy especially tend to show more psychiatric disturbances than do other epileptics, it is still not agreed whether an “epileptic psychosis” exists in its own right, any more than whether there is such an entity as the “epileptic personality”. The literature is full of contradictory statements and hypotheses. This is inevitable considering that epilepsy is a symptom-complex of diverse aetiology. However, within the total population of epileptics, it is possible to define groups with one or more common characteristics, e.g., similar pathology, localization, symptomatology, or inheritance. In studying the psychiatric manifestations it is probably better to try to relate them to such sub-groupings than to epileptics as a whole. The problem is of practical concern, for the incidence of epilepsy is between 0·4 and 0·5 per cent. of the general population (College of General Practitioners, 1960), while Pond and Bidwell (1959) in their survey of the practices of 14 family doctors pointed out that about a third of the epileptic patients had psychological difficulties.