Outcome after resective epilepsy surgery in the elderly.

Area of Science:

• Neurosurgery
• Epileptology
• Geriatric Medicine

Background:

• Resective epilepsy surgery is a treatment option for drug-resistant epilepsy.
• Outcomes in elderly patients (≥60 years) are less understood compared to younger populations.

Purpose of the Study:

• To compare complications, seizure control, and neuropsychological outcomes of resective epilepsy surgery in elderly patients versus younger controls.
• To evaluate the safety and efficacy of epilepsy surgery in older individuals.

Main Methods:

• Retrospective chart review of 2243 patients operated between 2000-2015.
• Inclusion of 20 elderly patients (≥60 years) and 60 matched younger controls (20-40 years).
• Comparison of postoperative seizure control (Engel classification) and surgical complications using chi-square statistics.

Main Results:

• Elderly patients had a higher surgical complication rate (65% vs. 27%, p=0.002).
• Seizure control was favorable in most elderly patients (75% Engel I/II at 12 months), though slightly less than controls (90%, p=0.092).
• Elderly patients showed preoperative impairment and postoperative worsening in memory, verbal skills, and mood.

Conclusions:

• Elderly patients can achieve favorable seizure control after resective epilepsy surgery.
• Advanced age is not an absolute contraindication for epilepsy surgery.
• Thorough presurgical evaluation is crucial for elderly patients undergoing epilepsy surgery.