Surgery for temporal lobe epilepsy in older patients

Object. The goal of this study was to evaluate the efficacy of surgery for temporal lobe epilepsy (TLE) in older (greater than or equal to 50 years of age) patients. Methods. The authors conducted a review of all patients 50 years of age or older with TLE surgically treated at the Montreal Neurological Institute an d Hospital since 1981 by one surgeon (A.O.). Only patients without a mass l esion were included. Outcome parameters were compared with those of younger individuals with TLE, who were stratified by age at operation. In patients aged 50 years and older, the onset of complex partial seizures occurred 5 to 53 years (mean 35 years) prior to the time of surgery. Postop eratively, over a mean follow-up period of 64 months, 15 patients (83%) obt ained a meaningful improvement, becoming either free from seizures or only experiencing a rare seizure. Most surgery outcomes were similar in both old er and younger individuals, except for a trend to more freedom from seizure s and increased likelihood of returning to work or usual activities in the younger patients. Note that a patient's long-standing seizure disorder did not negatively affect their ability to achieve freedom from seizures follow ing surgery. Conclusions. Surgery for TLE appears to be effective for older individuals, comparing favorably with results in younger age groups, and carries a smal l risk of postoperative complications.