gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Temporal and extratemporal epilepsy surgery in the elderly

Temporale und extratemporale Epilepsiechirurgie bei geriatrischen Patienten

Meeting Abstract

  • corresponding author Peter A. Winkler - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, München
  • C. Eroes - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, München
  • S. Arnold - Neurologische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, München
  • A. Peraud - Neurochirurgische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, München
  • S. Noachtar - Neurologische Klinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.08.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0086.shtml

Veröffentlicht: 23. April 2004

© 2004 Winkler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Data about epilepsy surgery in elderly patients especially with extratemporal epilepsy are rare. This study, was therefore aimed at evaluating the results of epilepsy surgery in elderly patients with temporal and extratemporal epilepsies.

Methods

Twenty patients (8 females, 12 males; mean age: 55,7, minimum: 50, maximum: 68) were included in this study with a mean follow-up of 47 (5-106) months. Fourteen patients with temporal lobe epilepsy and 6 with extratemporal epilepsy were included. Temporal resection included the anterior and mesial temporal structures. Extratemporal resections were frontal in all 6 cases and individually tailored, based on the results of the diagnostic evaluation.

Results

Seventeen patients (85%) were seizure free (class Ia, Engel 1993), one patient (5%) had an class II outcome and two patients (10%) were in outcome class III. All patients benefited from surgery. Outcome with regard to seizures was better in the temporal patients (Ia: 13=93%, III: 1=7%) than in the patients with frontal lobe epilepsies (Ia: 4=67%, II: 1=17%, III: 1=17%). Complications included a slight transient aphasia in one patient. Another patient had had a permanent mild ataxia and arm paresis secondary to an infarction in the territory of the superior cerebellar artery during angiography and amobarbital test. Six of the 14 temporal lobe epilepsy patients had hippocampal sclerosis, another 3 had tumours, 2 had dyplasias and 3 had other etiologies. The extratemporal etiologies were cavernomas (n=2), dysplasia (n=1) and 3 other etiologies.

Conclusions

The present study shows that epilepsy surgery in elder patients is associated with seizure outcome and morbidity comparable to younger adult epilepsy surgery candidates. Therefore, elder patients with pharmacoresistant temporal and extratemporal epilepsies should not be excluded from epilepsy surgery.