Abstracts

Objectives: To determine whether, there are significant differences in the clinical history, evaluation, complication rate and outcome, between younger and older patients undergoing surgery for temporal lobe epilepsy Sixty-four patients 40 years of age or older (group 1) with refractory temporal lobe epilepsy (TLE) underwent surgery following a comprehensive presurgical evaluation. We compared the history, clinical manifestations, surgical outcome, pathologic diagnosis, surgical outcome and the complication rate with 28 patients with TLE treated surgically at [lt] 18 years of age (group 2, and noted any significant differences) Group 1; 64 patients ( 40 yrs or [gt]): The age of seizure onset ranged from 1 yr to 46 yrs, the age at surgery from 40 yrs to 59 yrs. 23% had a history of febrile seizures ( FS), 81% had abnormal head MRIs, and 73% had abnormal FDG-PET scans, 18% required invasive recordings. Thirty seven patients underwent right and 27 had left sided resections. There was no surgical mortality, one patient (1.5%) had a mild hemiparesis. 63% became seizure free and 23% had rare seizures ( follow-up 1yr to 18 yrs). Group 2; 28 patients ([lt]18 yrs): The age of seizure onset ranged from 1 yr to 13 yrs, and the age at surgery from 8 yrs to 17 yrs. 54% had a history of FS, 62% had abnormal head MRIs, and 94% abnormal FDG-PET scans, 10% required invasive recordings. 54% had mesial temporal sclerosis.There was no surgical mortality, or complications. 79% became seizure free, and 7% had rare seizures ( follow-up 1 yr to 18 yrs) While the older patients had a favorable outcome, the younger patients who had a higher incidence of febrile convulsions, and less demand for invasive studies, fared even better, and had no complications, emphasizing the need for earlier surgical treatment