Efficacy and Safety of Epilepsy Surgery for Older Adult Patients with Refractory Epilepsy
Received 17 February 2020
Accepted for publication 14 March 2020
Published 25 March 2020 Volume 2020:16 Pages 195—199
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Naoki Ichikawa, Ayataka Fujimoto, Tohru Okanishi, Keishiro Sato, Hideo Enoki
Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Shizuoka, 430-8558, Japan
Correspondence: Ayataka Fujimoto
Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Nakaku, Hamamatsu, Shizuoka 430-8558, Japan
Purpose: The population of elderly patients with epilepsy has been growing rapidly and the chances of referring older patients with refractory epilepsy for surgical options could be increasing. In general, epilepsy surgery at higher ages has been less likely to be performed, because little is known regarding the risks and benefits in elderly patients. We, therefore, investigated surgical outcomes and comorbidities in a population ≥ 50 years old who underwent epilepsy surgery.
Methods: Patients ≥ 50 years old who underwent epilepsy surgery were identified from the database of our epilepsy center for the period from 2009 to 2017. Surgical complications and seizure outcome were reviewed, and seizure outcomes were evaluated using the International League Against Epilepsy (ILAE) surgery outcome scale.
Results: The mean age of 32 patients at the time of surgery was 56.1± 5.1 years. The mean duration of epilepsy was 23.4± 18.5 years and mean follow-up was 2.7± 2.0 years. As of the most recent visit, 56.3% of patients remained completely seizure-free (ILAE Class I). The surgery-related complication rate was 11.5%, comprising permanent deficits in 3.8% and transient deficits in 7.7%.
Conclusion: These results suggest that epilepsy surgery may represent a valuable approach in selected adult patients.
Keywords: epilepsy surgery, older adults, elderly, seizure outcome, complications
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