gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Age is not a limiting factor in older adults when considering resective temporal lobe epilepsy surgery

Das Alter spielt keine Rolle bei älteren Patienten mit resektiven epilepsiechirurgischen Eingriffen am Temporallappen

Meeting Abstract

  • presenting/speaker Valeri Borger - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Motaz Hamed - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Gülsah Aydin - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Christian E. Elger - Universitätsklinikum Bonn, Klinik für Epileptologie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV150

doi: 10.3205/19dgnc165, urn:nbn:de:0183-19dgnc1658

Veröffentlicht: 8. Mai 2019

© 2019 Borger et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Resective temporal lobe epilepsy surgery (RTLES) is well established as a method of treatment for patients with refractory temporal lobe epilepsy (rTLE). However, the majority of patients who underwent RTLES for rTLE are young adults. The number of older patients with newly diagnosed epilepsy is growing. Data reporting surgical outcomes from RTLES in older adults is scarce and age is often considered a limiting factor. The aim of the study was to report on RTLES for rTLE in patients aged 50 and older compared to younger candidates.

Methods: Patients with rTLE who underwent RTLES between 2012 and 2017 were reviewed from the epilepsy surgery database at our center. Inclusion criteria were age ≥18 at surgery and minimum completed 1-year follow-up (1y-FU) after RES. All patients were pre-surgically assessed in the department of epileptology and were considered to be suitable for surgery. The patients were divided into two groups according to age at time of surgery (group I: age 18–49; group II: age ≥ 50). The clinical features, seizure outcome and surgical complications were evaluated and compared between the two groups.

Results: Out of 184 patients who underwent RTLES in the study period, 144 patients met the inclusion criteria. 111 patients were aged 18–49 (group I), and 33 patients at age 50 and older (group II). The mean age at epilepsy onset (group I vs. group II: 16.95y±11.2 vs. 24.6y±16.3, p=0.008), the mean age at surgery (34y±8.9 vs. 56.58y±5.8, p=0.0001) and the duration of epilepsy (17.2y±11.09 vs. 31.97y±15.8, p=0.0001) differ significantly between the two groups. The post-op. seizure outcome at 1y-FU did not differ between younger and older patients (72% ILAE Class1 vs. 85% ILAE Class1, p=0.17). The surgical complications occurred in 18% in group II vs. 10% in group I, p=0.22. The permanent morbidity was 6% in group II vs. 2% in group I, p=0.22.

Conclusion: The results revealed that in selected older adults, RTLES leads to similar or even better post-operative seizure outcome as compared to younger candidates, despite the fact of later epilepsy onset and longer epilepsy duration. The rate of surgical complications and permanent morbidity did not differ between the two groups. Our findings show that when older adults are considered to be suitable for RTLES, age should not be the limiting factor in the decision making process.