Memory outcomes of temporal lobe surgery in adults aged over 45years.

Abstract

It is assumed that temporal lobe resection in older people is associated with worse seizure outcomes and potential postsurgical memory decline. We studied postsurgical memory development and surgical efficacy in patients over 45years of age compared with younger patients. We studied 88 patients (51 male and 37 female) after temporal lobe surgery, which involved hippocampal resection. The patients were evaluated before surgery and in the first (72 patients) and/or third (57 patients) postsurgical year. The Wechsler Memory Scale III test was performed to evaluate the MQ postsurgical development. Engel's classification was used to evaluate the postsurgical seizure outcome. The presurgical MQ (median 88) in ≥45years age group was significantly lower than in both younger groups (median MQ=100 for ≤30years age group, p=0.002; median MQ=107 for 31-44years age group, p=0.002). Three years after the surgery, the MQ decreased significantly in ≤30years age group (p=0.012), while only non-significant MQ decline was observed in both older groups. We found no significant impact of age on the surgical outcome. Higher age at the time of surgery does not significantly increase the risk for postsurgical memory decline; however, older patients are more likely to have lowered presurgical MQ. We did not find significant differences in the impact of surgery on seizure outcome among the age groups. Epilepsy surgery appears to be a safe and effective method in the age over 45years even though an earlier surgery should be preferred.