Resective surgery is seldom used in epilepsy patients aged 60 and older despite its potential to offer seizure freedom. Older age may deter referrals to specialized epilepsy centers given concern of increased surgical risk due to age and presence of other health problems common in the elderly.
A study reported today at the American Epilepsy Society 67th Annual Meeting has demonstrated that surgery in older epilepsy patients has potential to improve overall health and quality of life, as well as provide a favorable seizure outcome.
Investigators at UCLA reviewed the records of all patients who had undergone resective epilepsy surgery for medically refractory focal onset seizures at their institution between 1992 and 2012. Patients aged 60 years and older (range 60 -- 74) with a minimum follow up of one year (range 1 -- 7.5) were included in the study. Comorbidities at the time of surgery, including hypertension, hyperlipidemia, diabetes mellitus, hypothyroidism, osteoporosis, obstructive sleep apnea, depression and falls, were noted.
The investigators reported that resective epilepsy surgery is safe and effective in patients aged 60 and over. "Ninety percent of patients in our cohort had a good surgical outcome, with seventy percent of them becoming completely seizure free," says Sandra Dewar, RN, MS, CNS, the lead study author. "No patients had postoperative complications despite the majority having at least one comorbidity at the time of surgery. Our data demonstrates that referral to a comprehensive epilepsy center for resective epilepsy surgery evaluation should not be negatively influenced by advancing age. Consideration of surgery in older adults is important since seizure freedom may increase safety, independence and happiness later in life."
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