Temporal Lobe Epilepsy in Patients Older Than 50 Years.

Abstract

Surgery for Temporal Lobe Epilepsy in Older Patients Boling W, Andermann F, Reutens D, Dubeau F, Caporicci L, Olivier A J Neurosurg 2001;95:242–248 Objective The goal of this study was to evaluate the efficacy of surgery for temporal lobe epilepsy (TLE) in older (older than 50 years) patients. Methods The authors conducted a review of all patients aged 50 years or older with TLE surgically treated at the Montreal Neurological Institute and Hospital since 1981 by one surgeon (A.O.). Only patients without a mass lesion were included. Outcome parameters were compared with those of younger individuals with TLE, who were stratified by age at operation. Results In patients aged 50 years and older, the onset of complex partial seizures occurred 5 to 53 years (mean, 35 years) before the time of surgery. Postoperatively, over a mean follow-up period of 64 months, 15 (83%) patients obtained a meaningful improvement, becoming either free from seizures or experiencing only a rare seizure. Most surgery outcomes were similar in both older and younger individuals, except for a trend to more freedom from seizures and increased likelihood of returning to work or usual activities in the younger patients. Note that a patient's long-standing seizure disorder did not negatively affect the ability to achieve freedom from seizures after surgery. Conclusions Surgery for TLE appears to be effective for older individuals, comparing favorably with results in younger age groups, and carries a small risk of postoperative complications.