Table 2

Case reports of postoperative adjustment process

Type of changeBoN within epilepsy patients, ATL treatment, example of cases reportBoN within Parkinson's patients, DBS treatment, example of cases report
PsychologicalChanges in Self-concept: Patients perceived themselves differently ‘like a new person’ & ‘reborn’.6Change in Self-image, Feeling of Strangeness: ‘I don't seem to recognise myself without the problems I had before’.3 ‘I don’t recognise myself anymore; I haven't found myself again after the operation'.4
BehaviouralChanges in activities: ‘Excessive activity, increased sex drive, shirking and/or somatic complaints’.11Change in behaviour: 45-year-old female executive, before surgery, secretive about her illness: ‘As long as I have my work, I still exist: the day I can no longer go to work, it will be as if the curtain came down on my life’. After surgery: “I have a lot of work and prefer to spend time doing other things”. Unjustified leaves, announces disease to entourage, becomes active in an illness support association and wants ‘to be recognised as sick’.4
AffectiveChanges in mood: Fluctuations from euphoric to depressive phase, patients report ‘feeling on cloud nine’, ‘on top of the world’.6Apathy in absence of depressive syndrome: ‘Patients do not feel sad, have many plans and wish to do a lot of things, but they feel tired, ‘loss of vitality feeling’, they have difficulties in initiating actions’.16
SociologicalChanges in socio-familial dynamics and expectations: ‘Restructuring family dynamics 35%’.12Change in the couple & work dynamics: ‘64% of patients who were working before surgery wanted to stop their professional activity, and 65% of those who were married (or lived with a partner) experienced a conjugal crisis after operation’.3
  • Patients with epilepsy treated with ATL compared to Parkinson's patients treated with DBS.2–4 6–12 ,16