Surgery for temporal lobe epilepsy in older patients
Warren Boling
Warren Boling
Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; and Austin and Repatriation Medical Centre, Melbourne University, Melbourne, Australia
Frederick Andermann
Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; and Austin and Repatriation Medical Centre, Melbourne University, Melbourne, Australia
David Reutens
Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; and Austin and Repatriation Medical Centre, Melbourne University, Melbourne, Australia
François Dubeau
Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; and Austin and Repatriation Medical Centre, Melbourne University, Melbourne, Australia
Laetitia Caporicci
Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; and Austin and Repatriation Medical Centre, Melbourne University, Melbourne, Australia
André Olivier
Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; and Austin and Repatriation Medical Centre, Melbourne University, Melbourne, Australia
Object.The goal of this study was to evaluate the efficacy of surgery for temporal lobe epilepsy (TLE) in older (≥ 50 years of age) patients.
Methods.The authors conducted a review of all patients 50 years of age 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.
年龄在50岁及以上的患者,发病complex partial seizures occurred 5 to 53 years (mean 35 years) prior to the time of surgery. Postoperatively, over a mean follow-up period of 64 months, 15 patients (83%) obtained a meaningful improvement, becoming either free from seizures or only experiencing 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 their ability to achieve freedom from seizures following 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.
Address reprint requests to:Warren Boling, M.D., Department of Neurosurgery, Montreal Neurological Institute and Hospital, 3801 University, Montreal, Quebec, H3A 2B4, Canada. email:warren@bic.mni.mcgill.ca.
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