The safety and efficacy of epilepsy surgery for mesial temporal lobe epilepsy have been established. However, some patients show psychiatric comorbidity after epilepsy surgery. It is possible that psychiatric symptoms are induced by antiepileptic drugs (AED). An early withdrawal of AED after epilepsy surgery may be a risk factor for seizure recurrence.
Here we describe a case of a 19-year-old female who had intractable epilepsy. She also had focal impaired awareness seizures with epigastric rising sensation. She was diagnosed with right mesial temporal lobe epilepsy, and focus resection was thus performed. After epilepsy surgery she started having depression and aggression episodes. Therefore, the dosage of AED was reduced, and she started taking selective serotonin reuptake inhibitors at two months after surgery. Subsequently, psychiatric symptoms improved, and she remained seizure freedom.
Normal postoperative electroencephalogram findings, seizure freedom after epilepsy surgery, and complete resection may be the indications for the early withdrawal of AED.
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