Association of temporal lobe epilepsy and obsessive–compulsive disorder in a patient successfully treated with right temporal lobectomy

Abstract

A patient who developed obsessive–compulsive symptoms shortly after the onset of temporal lobe epilepsy exhibited almost complete remission after being rendered seizure-free by surgical intervention. These data support the hypothesis that temporal lobe epilepsy and obsessive–compulsive disorder (OCD) share at least some pathophysiological components. The diagnosis of temporal lobe epilepsy was made by ictal video/EEG recordings, concordant with the presence of a lesion in the posterior region of the temporobasal neocortex. The OCD was diagnosed on the basis of DSM-IV-TR criteria through a clinical interview while the intensity of the OCD symptoms was assessed with the Yape–Brown Obsessive–Compulsive Scale. Surgical intervention consisted of a complete lesionectomy in association with a right temporal lobectomy including both lateral and mesial structures. The patient had follow-up visits after 6 months and 1 year. At both times, the patient remained free of seizures and reported a progressive reduction in OCD symptomatology.