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

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.