Abstracts

RATIONALE: Demonstrate the effectiveness of surgery for epilepsy in a older patient population. Epilepsy affects potentially 2% of older Americans. Medications don[ssquote]t produce seizure freedom in many older Americans. Epilepsy surgery is an appropriate choice for patients with medically-refractory epilepsy. Surgery is a larger general risk in the older patient and consensus statements have argued against epilepsy surgery for the 50-year-old patient. Refractory older patient[ssquote]s outcome from surgery is infrequently reported. Successful outcomes from epilepsy surgery in older patients would help direct care choices.
METHODS: We retrospectively reviewed the patients from the Epilepsy Surgery Program at Froedtert Hospital-Medical College of Wisconsin for patients over the age of 49. Demography, evaluation results, and surgical outcomes were analyzed from our database.
RESULTS: Epilepsy surgery was performed on 23 patients over the age of 49. No demographic features were different from the young 112 patients except for age, age at onset, duration, and age of precipitating factor between the groups. Older patients were more likely to have a seizure-free outcome than young (88% vs. 68%). No significant operative or post-operative complications and no change in post-operative cognitive function except for pattern memory occurred between the groups. Age over 49 and later age of seizure onset were statistically predictors of better seizure outcome (p[lt]0.02,p=0.01).
CONCLUSIONS: Epilepsy surgery is a safe and effective treatment for medically-refractory epilepsy. Seizure-free rates, complications, and cognitive outcomes were the same or better than younger patients. Epilepsy surgery should be considered without age restriction.