Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

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Published Mar 4, 2015

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Temenuzhka Mihaylova Fawad Khan Henry Buchtel Oren Sagher Linda Selwa

Abstract

Abstract

Purpose: Resective epilepsy surgery for temporal lobe epilepsy (TLE) remains underutilized in elderly patients and only few studies report postsurgical seizure and neurocognitive outcomes in this group. The aim of this study was to investigate the tolerability and efficacy of surgery in older epileptics.

Methods: We conducted a retrospective analysis of 18 patients aged 55 or older to assess the efficacy and tolerability of the procedure. Mean disease duration was 34 years.

Results:  Fourteen patients (78%) achieved Engel class I outcome over a mean follow-up period of 4.2 years. Thirteen patients had neuroimaging and histopathology consistent with mesial temporal sclerosis (MTS). We did not find a measurable effect of disease duration on postsurgical outcome. We confirmed that the MRI evidence of MTS can be used as a predictor for postsurgical outcome. Postsurgical neuropsychological evaluation completed in 13 patients between three months and two and a half years post resection showed decline in verbal abilities most significantly in those who had undergone dominant temporal lobe surgery.

Discussion: Our results indicate that epilepsy surgery is well tolerated, safe and effective in older patients with refractory TLE. Postsurgical neuropsychological evaluation showed expected decline in verbal abilities in patients who had undergone dominant resection.

 

Article Details

How to Cite
MIHAYLOVA, Temenuzhka et al. Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients. Medical Research Archives, [S.l.], n. 2, mar. 2015. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/33>. Date accessed: 18 apr. 2024.
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Keywords
temporal lobe epilepsy, elderly patients, surgical outcome, cognitive function, brain MRI, seizure frequency
Issue
No 2 (2015)
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

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