Epilepsy With Psychiatric Comorbidities Unveils Prominent Temporal-Lobe MRI Lesions and Elevated Frontotemporal Interictal Discharges.

BACKGROUND

Psychiatric disorders are common in epilepsy, occurring 2 to 3 times more frequently than in the general population. The authors performed comprehensive assessments in epilepsy patients with psychiatric comorbidities to delineate their psychiatric comorbidities, informing accurate diagnosis and effective management.

METHODS

A total of 70 cases were included in the study. Patients were categorized into 2 groups: epilepsy with psychiatric comorbidities and epilepsy without psychiatric comorbidities. In this study, we integrate cognitive function assessments, psychiatric scales measuring anxiety and depression, 24-hour long-term video-electroencephalogram (VEEG) monitoring, and epilepsy-specific magnetic resonance imaging (MRI) sequences. The MRI sequences cover 3D T1-weighted and 3D FLAIR T2 oblique coronal views.

RESULTS

Cognitive function scores showed no significant intergroup differences ( P > 0.05). However, patients with psychiatric comorbidities demonstrated a significantly higher prevalence of structural brain abnormalities ( P = 0.008) and increased occurrence of interictal epileptiform discharges ( P = 0.012) compared with epilepsy without psychiatric comorbidities.

CONCLUSIONS

Epilepsy patients with psychiatric comorbidities demonstrate significantly higher proportion of abnormal brain MRI and EEG findings compared with patients without psychiatric comorbidities. These findings emphasize the necessity for comprehensive evaluations in epilepsy patients particularly those with psychiatric comorbidities.