Abstracts

Rationale: There are few reports of epilepsy surgery in older adults. We wished to compare the results of surgery between older and younger patients, to determine whether there are significant differences in the clinical manifestations, outcome and complications.Methods: Eighty-eight patients 40 yrs or >( group I) with TLE underwent surgery following a comprehensive presurgical evaluation. We compared the manifestations,outcome and complication rate with 30 patients treated surgically at < 18 yrs (group II), and noted the differences. Results: Group I: Age of seizure onset 1-46 yrs, age at surgery 40-66yrs, duration of epilepsy 3-55 yrs. 23% had febrile seizures(FS),16% head trauma,86% abnormal MRIs,76% abnormal PET. Fifty patients had right sided resections.There was no surgical mortality.69% became seizure free and 20% had rare seizures (follow-up 1-20 yrs). Three percent had permanent surgical complications. Group II: Age of seizure onset 1-13 yrs,age at surgery 8-17 yrs, duration of epilepsy 3-15 yrs. 53% had FS, 67% abnormal MRIs 90% abnormal PET scans. There was no surgical mortality or morbidity. 76% became seizure free, and 20% had rare seizures (follow-up 1-20yrs).Conclusions: Prolonged follow-up remains favorable,while the older patients benefited from surgery, the younger patients who had a higher incidence of febrile seizures fared even better, and had no complications, emphasizing the need for earlier surgical treatment