Temporal lobectomy outcome in older versus younger adults

Sirven, Joseph I; Malamut, Barbara L.; O’Connor, Michael J.; Sperling, Michael R.

doi:10.1212/wnl.54.11.2166

Cited by 109 publications

(72 citation statements)

References 5 publications

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“…Conversely, a Brazilian investigation reported no statistical difference of age at surgery with regard to postsurgical outcome after temporal lobectomy 22 . We did not observe a statistical difference regarding outcomes between patients younger and older than 50 years at the time of surgery (Table 5); the procedure proved to be safe and beneficial to both groups, which is in accordance with the literature 21 .…”

Section: Discussionsupporting

confidence: 89%

“…Additionally, Sirven et al 21 studied a large number of patients undergoing temporal lobectomy and observed that patients younger than 50 years had a higher likelihood of seizure freedom compared with those older than 50 years, although the procedure was considered safe and beneficial in both groups. Conversely, a Brazilian investigation reported no statistical difference of age at surgery with regard to postsurgical outcome after temporal lobectomy 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative outcome distribution according to age. Age I II III IV Total 10-19 7 3 0 3 13 20-29 21 3 1 2 27 30-39 39 17 5 8 69 40-49 44 18 4 4 70 50-59 28 11 1 0 40 60-69 5 4 0 1 10 Total 144 56 11 18 229 in other brain areas not involved in the primary epileptogenic zone, and this could be associated with the persistence of disabling seizures 19,20,21,22,23,24 . However, further clinical and experimental investigations are necessary to validate this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

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Shorter epilepsy duration is associated with better seizure outcome in temporal lobe epilepsy surgery

Meguins

Adry

Silva-Junior

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective: To investigate the influence of patient's age and seizure onset on surgical outcome of temporal lobe epilepsy (TLE). Method: A retrospective observational investigation performed from a cohort of patients from 2000 to 2012. Results: A total of 229 patients were included. One-hundred and eleven of 179 patients (62%) were classified as Engel I in the group with , 50 years old, whereas 33 of 50 (66%) in the group with $ 50 years old group (p = 0.82). From those Engel I, 88 (61%) reported epilepsy duration inferior to 10 years and 56 (39%) superior to 10 years (p , 0.01). From the total of patients not seizure free, 36 (42%) reported epilepsy duration inferior to 10 years and 49 (58%) superior to 10 years (p , 0.01). Conclusion: Patients with shorter duration of epilepsy before surgery had better postoperative seizure control than patients with longer duration of seizures.Keywords: temporal lobe epilepsy, age at surgery, epilepsy duration, seizure outcome. RESUMOObjetivo: Investigar a influência da idade no momento da cirurgia e duração das crises no resultado cirúrgico da epilepsia do lobo temporal (ELT). Método: Estudo observacional retrospectivo de uma coorte de pacientes de 2000 a 2012. Resultados: Um total de 229 pacientes foram incluídos. Cento e onze de 179 pacientes (62%) foram classificados como Engel I no grupo com , 50 anos de idade, ao passo que 33 de 50 (66%) no grupo com $ 50 anos grupo de idade (p = 0,82). Daqueles Engel I, 88 (61%) relataram a duração da epilepsia inferior a 10 anos e 56 (39%) superiores a 10 anos (p , 0,01). Do total de pacientes não sem crises, 36 (42%) relataram a duração da epilepsia inferior a 10 anos e 49 (58%) superior a 10 anos (p , 0,01). Conclusão: Pacientes com menor duração da epilepsia antes da cirurgia tem melhor controle das crises pós-operatório.Palavras-chave: epilepsia do lobo temporal, idade no momento da cirurgia, duração da epilepsia, controle das crises.Epilepsy is the most common chronic neurological disease, affecting 0.4% to 1% of the general population. The cumulative incidence of seizure is thought to be approximately 10% to age 74 years, and the lifetime likelihood of receiving a diagnosis of epilepsy is almost 3% 1 . Temporal lobe epilepsy (TLE) is the most common epilepsy syndrome and affects almost 40% of epilepsy patients. Several risk factors are associated with epilepsy, such as prolonged childhood febrile seizure, status epilepticus, central nervous system (CNS) infections, head trauma, neoplasm, perinatal/vascular insults, mesial temporal lobe sclerosis (MTS), and a family history of epilepsy 2,3,4 . These risk factors are thought to cause brain injury at a molecular level, leading to either biologic or morphologic changes over years, ultimately leading to the development of refractory epilepsy 5 . Epilepsy surgery has been shown to be an effective treatment, especially for patients with refractory TLE associated with MTS (TLE-MTS), and 60% to 70% experience seizure remission 6,7,8,9 . Therefore, determining presurgical prognost...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Shorter epilepsy duration is associated with better seizure outcome in temporal lobe epilepsy surgery

Meguins

Adry

Silva-Junior

et al. 2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Sirven et al [20] compared postsurgical seizure outcome, neuropsychological test scoring and driving status in 30 patients aged 50 and older (median age 51.9) to 340 younger patients (median age 32.8). 53% of the older patients were seizure free as compared to 75% in the younger group.…”

Section: Discussionmentioning

confidence: 99%

“…However, few articles have reported encouraging results comparable to those in younger patients with refractory TLE [4,5,20]. There are only a few studies in older adults which evaluate postsurgical neurocognitive outcome.…”

Section: Introductionmentioning

confidence: 99%

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

Mihaylova¹,

Khan²,

Buchtel³

et al. 2015

MRAJ

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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 Medical Research Archives 2015Issue 2Copyright © 2015, Knowledge Enterprises Incorporated. All rights reserved. 2 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/Conclusion-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.

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Paediatric Epilepsy Surgery

Lawson¹,

Duchowny²

2004

The Treatment of Epilepsy

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Temporal lobectomy outcome in older versus younger adults

Cited by 109 publications

References 5 publications

Shorter epilepsy duration is associated with better seizure outcome in temporal lobe epilepsy surgery

Shorter epilepsy duration is associated with better seizure outcome in temporal lobe epilepsy surgery

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

Paediatric Epilepsy Surgery

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