Epilepsy surgery in patients in their middle and late adulthood
Abstract number :
1.328
Submission category :
9. Surgery / 9A. Adult
Year :
2017
Submission ID :
348676
Source :
www.aesnet.org
Presentation date :
12/2/2017 5:02:24 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Asier Gómez-Ibañez, Hospital Politécnico y Universitario La Fe, Valencia; Mercedes Garces, Hospital Politécnico y Universitario La Fe, Valencia; Rebeca Conde, Hospital Politécnico y Universitario La Fe, Valencia; Kevin Hampel, Hospital Politécnico y Unive
Rationale: Surgery can be an effective treatment for patients with refractory epilepsy. However, the published series include mostly children and young adults, with scarce data about outcomes in patients who underwent surgery in middle and late adulthood. Endpoint is to evaluate the outcome of patients with refractory epilepsy who underwent an epilepsy surgery in middle and late adulthood. Methods: This is a retrospective study based on clinical records of patients who underwent an epilepsy surgery when they were ≥50 years-old, within Hospital La Fe Epilepsy Surgery Programm (2006-2017) Results: We identified 40 patients ≥50 years-old (22 males, 18 females) out of a total of 335 patients who had an epilepsy surgery in our hospital(11.9%); 9 (2.7%) were ≥60 years-old. Mean age at surgery was 55.9 years (50-69), with mean epilepsy duration of 42.5 years (4-67); patients were referred to an Epilepsy Unit a mean of 41.4 years after the diagnosis (3-66). Before surgery, mean seizure frequency was 8.8 per month. Neuroimaging showed focal epileptogenic lesions in 36/40 patients, mainly mesial temporal sclerosis (25). Presurgical neuropsichology evaluation was available in 26 patients: 24 had any deficit (92,3%), mostly in verbal or visual memory (20).Standard temporal lobectomy with amygdalohyppocampectomy was performed in 25 patients, lessionectomy in 7, lobectomy in 3, lobectomy with selective amygdalectomy in 1, VNS in 3 (1 with corpus callosotomy afterwards) and one had undergone only stereoelectroencephalography (S-EEG). Mean follow-up was 51.8 months (1-119). A good outcome was achieved by 82.7% (27 Engel I; 7 Engel II); 6 patients were studied with SEEG, without any complications. After surgery, 12/21 had cognitive impairment, 6 had depression and 1 had a transient hemiparesis Conclusions: Surgical treatment of long-term refractory epilepsy in patients ≥50 years-old can be effective. Post-surgical cognitive decline is a frequent side effect in this age group patients. Funding: We have not received any funding in support of this abstract
Surgery