The role of personality disorders in the management of patients with pharmacoresistant epilepsy after neurosurgical resections

The review focuses on the problem of personality disorders that arise in patients with pharmaco-resistant epilepsy after neurosurgical resections. We analyzed 47 research articles, selected by keywords from Russian and international databases for 2010–2017. It was found that, despite the achievements in epilepsy surgery and the high percentage of remission in the postoperative period, the problem of personality disorders remains important. The most frequent postoperative personality disorders are anxiety and depression, which greatly exacerbate the course of the postoperative period and make it difficult for the patient to adapt in society because of his internal stigmatization. In addition, depression can provoke the aggravation of epileptic seizures in the postoperative period. Psychiatric anamnesis and a severe form of depression in the preoperative period are the powerful predictors of the depression onset in the postoperative period. Despite this, there are no psychiatric contraindications to the surgical treatment of pharmaco-resistant epilepsy. The authors discuss the need for perioperative psychiatric testing of patients suffering from epilepsy.