Background: The age of onset of seizure, seizure types, frequency of seizure, structural abnormalities in the brain, and antiepileptic medication (polytherapy) causes increased incidence of anxiety and depression in intractable epilepsy patients.
Aim: To compare the anxiety and depression levels in intractable epileptic patients with structural abnormalities [malformations of cortical development (MCD) and incomplete hippocampal inversion (IHI)] and without structural abnormalities.
Materials and Methods: Participants were selected from (239 males and 171 females) intractable epilepsy patients. They were grouped into four groups; Group 1: 51 nonepileptic age-matched controls, Group 2: 41 intractable epilepsy patients without any brain abnormality, Group 3: 17 intractable epilepsy patients with MCD, and Group 4: 30 intractable epilepsy patients with isolated IHI. Neuropsychiatric tools used were Multiphasic Personality Questionnaire and Weschlers Adult Intelligence Scale to assess anxiety, depression, and intelligence. Groups were classified using 1.5T conventional magnetic resonance imaging and hippocampal volumetric studies. Group comparison design was used.
Results: Demographic variables of intractable epilepsy, including seizure types, the frequency of seizure, the age of seizure onset, and antiepileptic drug therapies, did not show significant association between the groups using Chi-square P value. Analysis of variance showed significant anxiety and depression in epileptic patients than the control group (P < 0.01). Post hoc analysis using Tukey's B test showed significant difference in anxiety and depression scores between group value. In group 3 and 4, anxiety scores were significantly different but not depression scores.
Conclusion: The present study concludes high prevalence of anxiety and depression in intractable seizure. Anxiety is observed predominantly when there is IHI along with depression. We emphasize the need to identify IHI in intractable epilepsy and assess anxiety and depression to treat them effectively.


中文翻译：

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海马不完全倒置与顽固性癫痫的关系：来自神经心理学研究的证据


背景：癫痫发作年龄、癫痫发作类型、癫痫发作频率、大脑结构异常和抗癫痫药物（综合疗法）导致难治性癫痫患者焦虑和抑郁的发生率增加。
目的：比较具有结构异常[皮质发育畸形（MCD）和不完全海马倒置（IHI）]和无结构异常的顽固性癫痫患者的焦虑和抑郁水平。
材料和方法：参与者选自（239 名男性和 171 名女性）难治性癫痫患者。他们被分成四组；第 1 组：51 名非癫痫年龄匹配的对照组，第 2 组：41 名无任何脑部异常的顽固性癫痫患者，第 3 组：17 名患有 MCD 的顽固性癫痫患者，第 4 组：30 名患有孤立性 IHI 的顽固性癫痫患者。使用的神经精神病学工具是多相人格问卷和韦施勒成人智力量表来评估焦虑、抑郁和智力。使用 1.5T 常规磁共振成像和海马体积研究对组进行分类。采用组比较设计。
结果：难治性癫痫的人口统计学变量，包括癫痫发作类型、癫痫发作频率、癫痫发作年龄和抗癫痫药物治疗，使用卡方P值未显示各组之间的显着关联。方差分析显示癫痫患者焦虑、抑郁情绪明显高于对照组（P <0.01）。使用 Tukey's B 检验的事后分析显示， 组值之间的焦虑和抑郁评分存在显着差异。在第 3 组和第 4 组中，焦虑评分显着不同，但抑郁评分无显着差异。
结论：本研究得出结论，在顽固性癫痫发作中焦虑和抑郁的患病率很高。焦虑主要在 IHI 和抑郁症出现时观察到。我们强调需要在难治性癫痫中识别 IHI，并评估焦虑和抑郁以有效治疗它们。