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Objective: To compare the effects of different surgical strategies in patients with various types of epilepsy accompanying mental symptoms.

Methods: The clinical and follow-up data of 65 patients with epilepsy accompanying mental symptoms admitted to our department from January 2014 to December 2016 were retrospectively analyzed. Patients were categorized into two types using self-made evaluation scales based on the degree of correlation between their mental symptoms and seizures. Type I (n=28) exhibited a high correlation and was treated with a combined craniotomy, while Type II (n=37), characterized by a low correlation, underwent treatment using multi-target stereotactic radiofrequency thermocoagulation.

Results: (1) the ORR was 90.77%, while the RR was 89.29% and 91.89% in type Ⅰ and type Ⅱ patients, respectively; (2) the ORR for epilepsy treatment was 86.15%, the RR was 89.29% and 83.78% in patients of type Ⅰ and Ⅱ respectively; (3) the total scores significantly decreased in BPRS, SAPS and SANS after surgery and there were significant statistical differences compared with those before surgery (P<0.05).

Conclusion: (1) Active surgical treatment significantly reduces the frequency of epileptic seizures, alleviates mental symptoms and improves quality of life for patients with epilepsy accompanying mental symptoms; (2) The self-made evaluation scale contributes to selecting the appropriate surgical method and predicts a favorable prognosis.