Abstracts

Rationale: The number of elderly patients with epilepsy in Japan is increasing as a consequence of the “aging” society. Although epilepsy in the elderly has been known as anti-epileptic drug responsive, solutions are difficult in drug resistant cases. Therefore, we investigated surgical efficacy for elderly patients with drug resistant temporal lobe epilepsy (TLE). Methods: We treated 12 patients 50-year-old and above with drug resistant TLE who had focus resection or hippocampal transection (HT) at the Juntendo University epilepsy center, Tokyo, Japan, from 2006 to 2017. We excluded those with tumors and vascular pathology related to TLE from the study. We compared the surgical result of the elderly to that of operated patients less than 50 years for the same etiologies (n=93). We evaluated seizure outcome by Engel’s classification 2 years after surgery, memory outcome, and surgically related complications. Memory functions before and after surgery were compared using the Wechsler Memory Scale–Revised (WMS-R), Japanese edition. Results: Engel’s class 1 outcome was achieved in 91.6% in the elderly patients, however class Ia outcome was 66.7%. Seizure outcome in the elderly was not different from that of the younger patient group. All categories of WMS-R declined by almost 10. Left side epileptic focus was significantly related to verbal memory decline. Delayed recall was 71.3 after surgery from 85.3 in patients over 60 years old. No surgically related complications occurred. Conclusions: Surgical treatment should be considered for elderly patients with drug resistant TLE. Surgical results were satisfactory and similar to those in younger patients. There was slight memory decline, especially verbal memory in patients with a dominant side epileptic focus and delayed recall in patients elder than 60 years. Funding: No funding