SUMMARYPurpose: Neurosurgery is an effective therapy for selected individuals with medically refractory temporal lobe epilepsy (TLE). De novo psychopathology may complicate the postsurgical outcome. Our aims were to identify predictors of de novo psychiatric and seizure outcome following TLE surgery. Methods: Medical records of 280 patients who underwent TLE surgery were reviewed. Preoperative and postoperative psychiatric diagnoses were identified, in addition to information on seizure recurrence and neuropsychological status. Logistic regression analysis was used to identify predictors of having a de novo psychiatric diagnosis and remaining seizure-free within 4 years following surgery. Key Findings: One hundred five patients (38%) had significant psychiatric problems within 4 years following TLE surgery. Fifty-one patients (18%) developed de novo psychopathology; half of cases presented within 6 months and 90% of psychopathologies persisted 6 months or longer. A preoperative history of secondary generalized tonic-clonic seizure(s) (SGTCS) was an independent predictor of de novo psychopathology (odds ratio [OR] 2.73, 95% confidence interval [CI] 1.14-6.59, p = 0.02). From patients with available seizure data, 49% (127 of 258) remained seizure-free for 4 years after surgery. Patients with a history of SGTCS (OR 0.47, 95% CI 0.25-0.90, p = 0.02) and those with a preoperative psychiatric diagnosis (OR 0.53, 95% CI 0.28-0.98, p = 0.04) were significantly less likely to remain seizure-free. Significance: De novo psychopathology is a significant complication of TLE surgery. Inclusion of neuropsychiatric assessments in the presurgical evaluation may lead to increase in the power of prognostic models used to predict the neurologic outcome of TLE surgery.

A variety of psychiatric diagnoses can occur in children with pediatric MS. Many of these children also had cognitive impairment, particularly those in the mood and anxiety groups.

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a b s t r a c tIntroduction: Parkinson's disease (PD) can impact enormously on speech communication. One aspect of non-verbal behaviour closely tied to speech is co-speech gesture production. In healthy people, co-speech gestures can add significant meaning and emphasis to speech. There is, however, little research into how this important channel of communication is affected in PD. Methods: The present study provides a systematic analysis of co-speech gestures which spontaneously accompany the description of actions in a group of PD patients (N ¼ 23, Hoehn and Yahr Stage III or less) and age-matched healthy controls (N ¼ 22). The analysis considers different co-speech gesture types, using established classification schemes from the field of gesture research. The analysis focuses on the rate of these gestures as well as on their qualitative nature. In doing so, the analysis attempts to overcome several methodological shortcomings of research in this area. Results: Contrary to expectation, gesture rate was not significantly affected in our patient group, with relatively mild PD. This indicates that co-speech gestures could compensate for speech problems. However, while gesture rate seems unaffected, the qualitative precision of gestures representing actions was significantly reduced. Conclusions: This study demonstrates the feasibility of carrying out fine-grained, detailed analyses of gestures in PD and offers insights into an as yet neglected facet of communication in patients with PD. Based on the present findings, an important next step is the closer investigation of the qualitative changes in gesture (including different communicative situations) and an analysis of the heterogeneity in co-speech gesture production in PD.