Children with temporal lobe epilepsy and depression

Psychiatric evaluation is shown to be important for children with temporal lobe epilepsy.

Depressive symptoms, behavioural problems and psychiatric illnesses are common among children and adolescents with temporal lobe epilepsy, a new study has shown.

Researchers at the Children's National Medical Centre in Washington DC, US, say their findings underline the importance of carrying out full psychiatric evaluations on children with epilepsy, particularly if they are not responding to anti-seizure medications and may be eligible for epilepsy surgery.

The research team looked at case records for 40 children, aged six to 17 years, who were not benefiting from anti-seizure medications.

Patients received psychiatric evaluations prior to undergoing epilepsy surgery, while their parents completed questionnaires aimed at assessing their children's behaviour.

Previous research suggests that up to 40 per cent of children with chronic epilepsy have mental illnesses, with depression, anxiety, attention issues and learning difficulties being most common.

However, the latest study found the rate of psychiatric and behavioural problems to be far higher.

Overall, nearly 80 per cent of the children had significant psychiatric symptoms.

The researchers also observed that children with temporal lobe epilepsy were more likely to have depressive symptoms and significant behavioural issues than those whose seizures originated in other parts of the brain.

Their study, which is published in the journal Epilepsia, is not the first to suggest a link between temporal lobe epilepsy and depression, as previous research in a 2009 issue of the same journal found an association in adult patients.

However, the latest study indicates that this link extends to children with epilepsy as well.

"Understanding the paediatric patient's mental health status is important, as the severity of psychiatric illness may impact the overall risk-benefit of epilepsy surgery," explained Dr Jay Salpekar, the study's lead author.

"Given that psychiatric illness, particularly depression, is so prominent in those with temporal lobe seizures, routine psychiatric evaluation appears to be important not only for adults, but also for children and adolescents prior to epilepsy surgery.

"In fact, it may be beneficial for most patients with medically refractory epilepsy to have a psychiatric assessment, regardless of seizure localisation, to improve quality of life."

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