Psychiatric complications after epilepsy surgery… but where are the psychiatrists?

Rebecca Ellen Fasano, Andres M Kanner

Research output: Contribution to journalArticle


In patients with refractory epilepsy, there is a significant risk of postoperative psychiatric complications after epilepsy surgery. The main risk factors for this phenomenon include a lifetime or family history of psychiatric illness; these risk factors can be easily identified through a preoperative evaluation performed by a psychiatrist. Despite this, very few comprehensive epilepsy centers include a psychiatrist on the treatment team. Preoperative evaluations often fail to identify patients at risk of postoperative psychiatric complications, thus missing the opportunity to counsel and prophylactically treat patients at risk. In this article, we review the risk factors for the development of postoperative psychiatric complications and discuss the reasons why epilepsy centers continue to perform presurgical evaluations without psychiatrists. Additionally, we provide practical solutions for neurologists in the identification and management of postoperative psychiatric disorders. This article is part of the Special Issue entitled “Obstacles of treatment of psychiatric comorbidities in epilepsy”.

Original languageEnglish (US)
JournalEpilepsy and Behavior
StateAccepted/In press - Jan 1 2019



  • Epilepsy surgery
  • Psychiatric comorbidities
  • Psychiatric complications
  • Treatment-resistant epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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