Long term effects of temporal lobe craniotomy for ganglioglioma

[Bety__0__0]

  My son underwent craniotomy for an anterior temporal lobe ganglioglioma with oligodendroglial component in Aug. '95 at age 16. His symptoms were absence seizures and depression. The surgery was successful and he has not had to undergo chemo or radiation treatment. Since the surgery he has been on Neurontin due to allergic reactions to tegretol and dilantin. He was not prescribed anti-depressants after the surgery. However, he continued to demonstrate symptoms of depression which escalated a year after the surgery. He has been on 150 mg. of Zoloft since Dec. 96, is under the care of a psychiatrist and has undergone individual therapy with a psychologist. Their findings are that he is borderline depressed with anxiety.  We've been told he might need to stay on the antidepressant indefinitely. Until his surgery, he was an excellent student. He has experienced difficulty with academics, particularly the first two years and still has difficulty with his memory. He has had neuropsychological testing twice showing him in the superior intelligence range with no significant deficits. However, he forgets appointments, names, directions, etc. which he never did before.
  My questions are concerning the depression and the memory lapses. Are these conditions "normal or ordinary" in a case like his? Is depression a by product of a disease and surgery like his in the temporal lobe? Should we expect these conditions to continue indefinitely? Thank you.

[CCF Neurosurgery MD/GM]

Dear Betty:
It is difficult to answer your questions specifically without knowing exactly what the extent of the surgical resection was. Some people do experience memory loss or speech difficulty. Depression however, although may occur but it is difficult to say whether it is a by-product of the disease or surgery. Typically memory deficits are not serious or permanent because there are other areas in the brain that have good control of memory and can compensate (so to speak). If he has not had an MRI recently I think that he should undergo this as it may shed some light on what is going on. If there is no structural cause for this then you should see whether the antidepressant medication has any effect on him and observe his progress. Only time will tell how things will change but I am hopeful that this should get better.
I hope this helps. Good Luck!