Epilepsy Surgery May Be Very Effective in Elderly Patients

Three quarters of patients older than 60 were seizure-free after surgery, a study finds.

BALTIMORE—Most elderly patients with epilepsy have no seizures or complications after undergoing epilepsy surgery, epilepsy specialists reported at the 65th Annual Meeting of the American Epilepsy Society. After surgery and a median follow-up of 13.5 months, 75% of patients were seizure-free.

Najib Murr, MD, Assistant Professor of Neurology at the University of Nebraska medical center, and colleagues retrospectively analyzed various outcome measures of all patients older than 60 who had epilepsy surgery at the Neurology Department of Vanderbilt University Medical Center in Nashville between January 1, 2000, and December 31, 2010. The team identified 24 patients who met their inclusion criteria.

Gender, age at epilepsy onset, seizure risk factors, epilepsy duration, and seizure frequency were among the variables that were recorded. The team also noted patients’ type of epilepsy, complications after surgery, the duration of postsurgery follow-up, and the Engel classification for seizure control.

Patient Characteristics
The median age at which patients had surgery was 62, and half of patients were female. Epilepsy onset occurred among patients at a median age of 28, and the disorder lasted for a median of 36 years.

The researchers found that about 21% had tried and abandoned as many as seven antiepileptic drugs (AEDs). In addition, 79% of patients were taking more than two AEDs at the time of their initial evaluation. In 88% of patients, seizures were localized in the left or right temporal lobe. MRIs revealed abnormalities in 83% of subjects, and 54% of patients had abnormal PET scans.

Patients’ Postsurgery Status
Most patients (54%) underwent selective amygdalo-hippocampectomy. After surgery, about 4% of patients had persistent complications (eg, superior quadrantanopia). Outcome for 50% of patients was rated Engel class 1 for seizure control two years after the surgery. In addition, patients with an older age of epilepsy onset, a shorter duration of epilepsy, or an older age at time of surgery had a higher chance of being free of seizures. However, these results were not statistically significant.

“In the elderly, epilepsy surgery results in excellent seizure-free outcomes with low risk of complications,” reported Dr. Murr. “Epilepsy surgery should be strongly considered in older patients with drug-resistant partial epilepsy,” he concluded.

Three quarters of patients older than 60 were seizure-free after surgery, a study finds.

BALTIMORE—Most elderly patients with epilepsy have no seizures or complications after undergoing epilepsy surgery, epilepsy specialists reported at the 65th Annual Meeting of the American Epilepsy Society. After surgery and a median follow-up of 13.5 months, 75% of patients were seizure-free.

Najib Murr, MD, Assistant Professor of Neurology at the University of Nebraska medical center, and colleagues retrospectively analyzed various outcome measures of all patients older than 60 who had epilepsy surgery at the Neurology Department of Vanderbilt University Medical Center in Nashville between January 1, 2000, and December 31, 2010. The team identified 24 patients who met their inclusion criteria.

Gender, age at epilepsy onset, seizure risk factors, epilepsy duration, and seizure frequency were among the variables that were recorded. The team also noted patients’ type of epilepsy, complications after surgery, the duration of postsurgery follow-up, and the Engel classification for seizure control.

Patient Characteristics
The median age at which patients had surgery was 62, and half of patients were female. Epilepsy onset occurred among patients at a median age of 28, and the disorder lasted for a median of 36 years.

The researchers found that about 21% had tried and abandoned as many as seven antiepileptic drugs (AEDs). In addition, 79% of patients were taking more than two AEDs at the time of their initial evaluation. In 88% of patients, seizures were localized in the left or right temporal lobe. MRIs revealed abnormalities in 83% of subjects, and 54% of patients had abnormal PET scans.

Patients’ Postsurgery Status
Most patients (54%) underwent selective amygdalo-hippocampectomy. After surgery, about 4% of patients had persistent complications (eg, superior quadrantanopia). Outcome for 50% of patients was rated Engel class 1 for seizure control two years after the surgery. In addition, patients with an older age of epilepsy onset, a shorter duration of epilepsy, or an older age at time of surgery had a higher chance of being free of seizures. However, these results were not statistically significant.

“In the elderly, epilepsy surgery results in excellent seizure-free outcomes with low risk of complications,” reported Dr. Murr. “Epilepsy surgery should be strongly considered in older patients with drug-resistant partial epilepsy,” he concluded.

Three quarters of patients older than 60 were seizure-free after surgery, a study finds.

BALTIMORE—Most elderly patients with epilepsy have no seizures or complications after undergoing epilepsy surgery, epilepsy specialists reported at the 65th Annual Meeting of the American Epilepsy Society. After surgery and a median follow-up of 13.5 months, 75% of patients were seizure-free.

Najib Murr, MD, Assistant Professor of Neurology at the University of Nebraska medical center, and colleagues retrospectively analyzed various outcome measures of all patients older than 60 who had epilepsy surgery at the Neurology Department of Vanderbilt University Medical Center in Nashville between January 1, 2000, and December 31, 2010. The team identified 24 patients who met their inclusion criteria.

Gender, age at epilepsy onset, seizure risk factors, epilepsy duration, and seizure frequency were among the variables that were recorded. The team also noted patients’ type of epilepsy, complications after surgery, the duration of postsurgery follow-up, and the Engel classification for seizure control.

Patient Characteristics
The median age at which patients had surgery was 62, and half of patients were female. Epilepsy onset occurred among patients at a median age of 28, and the disorder lasted for a median of 36 years.

The researchers found that about 21% had tried and abandoned as many as seven antiepileptic drugs (AEDs). In addition, 79% of patients were taking more than two AEDs at the time of their initial evaluation. In 88% of patients, seizures were localized in the left or right temporal lobe. MRIs revealed abnormalities in 83% of subjects, and 54% of patients had abnormal PET scans.

Patients’ Postsurgery Status
Most patients (54%) underwent selective amygdalo-hippocampectomy. After surgery, about 4% of patients had persistent complications (eg, superior quadrantanopia). Outcome for 50% of patients was rated Engel class 1 for seizure control two years after the surgery. In addition, patients with an older age of epilepsy onset, a shorter duration of epilepsy, or an older age at time of surgery had a higher chance of being free of seizures. However, these results were not statistically significant.

“In the elderly, epilepsy surgery results in excellent seizure-free outcomes with low risk of complications,” reported Dr. Murr. “Epilepsy surgery should be strongly considered in older patients with drug-resistant partial epilepsy,” he concluded.