Abstract:
OBJECTIVE: We sought to determine whether the frequency of
depressive disorders among patients with complex partial seizures is
associated with the laterality of ictal onset or the laterality of
interictal cerebral hypometabolism. DESIGN: Fifty-three patients with
medically intractable complex partial seizures were assessed for history
of interictal depressive disorders meeting strict Diagnostic and
Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-
R), criteria with use of a modification of the Structured Clinical
Interview for DSM-III-R. All subjects underwent video-
electroencephalographic telemetry and fludeoxyglucose F18 positron
emission tomographic scanning. The main outcome measure was the
frequency of a history of major depressive episodes (MDEs) in subjects
with left-sided vs right-sided ictal onset and in subjects with left-
sided vs right-sided temporal lobe hypometabolism. RESULTS: Thirty-
three subjects (62%) had a history of interictal depressive disorders,
16 (30%) of whom met criteria for one or more MDEs. More of those with
left-sided ictal onset had a history of depression. Thirty-six subjects
had definite unilateral temporal lobe hypometabolism demonstrated by
positron emission tomographic scanning. More of those with left temporal
lobe hypometabolism had a history of MDEs, and the combination of left
temporal lobe hypometabolism and high-degree hypometabolism was strongly
associated with a history of MDEs. Furthermore, among those with right
temporal lobe hypometabolism, more of those with high-degree
hypometabolism had a history of MDEs. CONCLUSION: Laterality of ictal
onset and degree of interictal temporal lobe hypometabolism may be
interdependent factors that contribute to the risk of depressive
disorder in patients with complex partial seizures