Anterior temporal lobectomy for older adults with mesial temporal sclerosis

Lidia M.V.R. Moura, Emad N. Eskandar, Mursal Hassan, Joel Salinas, Andrew J. Cole, Daniel B. Hoch, Sydney S. Cash, John Hsu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective To compare postoperative seizure-free survival between older and younger adults. Methods A retrospective cohort of 107 temporal lobe epilepsy patients with a diagnosis of mesial temporal sclerosis (MTS) received anterior temporal lobectomy (ATL) between 1993 and 2014. We divided the lower three quartiles (younger) and top quartile (older, all 47+ years) of patients, then reviewed patient registry and electronic medical records to determine time to first self-reported seizure after ATL, the primary outcome (mean = 3.5 years of follow-up, SD = 3.6). We also assessed Engel classifications, intraoperative and postoperative treatment complications, and social disability. We used Cox proportional hazard models to assess the association between individual traits and time of seizure recurrence. Results During follow-up, 35/107 (32.7%) patients had post-operative seizure(s). After adjustment for potential confounders there were no significant differences in the probability of post-operative seizures between the older and younger groups, though we had limited precision (hazard ratio of 0.67 [0.28–1.59]), (p = 0.36). There were more treatment complications and disability in older patients (18% vs. 1.3% for any complications, 84.62% vs. 58.23% for driving disability, and 84.6% vs. 60.7% for work disability, p < 0.05). Conclusion Older patients appear to have more complications after ATL, compared with younger patients. Age, however, does not appear to have a large independent association with seizure recurrence.

Original languageEnglish (US)
Pages (from-to)358-365
Number of pages8
JournalEpilepsy Research
Volume127
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Fingerprint

Anterior Temporal Lobectomy
Sclerosis
Seizures
Recurrence
Temporal Lobe Epilepsy
Electronic Health Records
Proportional Hazards Models
Registries
Young Adult
Survival

Keywords

  • Age
  • Anterior temporal lobectomy
  • Mesial temporal sclerosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Moura, L. M. V. R., Eskandar, E. N., Hassan, M., Salinas, J., Cole, A. J., Hoch, D. B., ... Hsu, J. (2016). Anterior temporal lobectomy for older adults with mesial temporal sclerosis. Epilepsy Research, 127, 358-365. https://doi.org/10.1016/j.eplepsyres.2016.09.021

Anterior temporal lobectomy for older adults with mesial temporal sclerosis. / Moura, Lidia M.V.R.; Eskandar, Emad N.; Hassan, Mursal; Salinas, Joel; Cole, Andrew J.; Hoch, Daniel B.; Cash, Sydney S.; Hsu, John.

In: Epilepsy Research, Vol. 127, 01.11.2016, p. 358-365.

Research output: Contribution to journalArticle

Moura, LMVR, Eskandar, EN, Hassan, M, Salinas, J, Cole, AJ, Hoch, DB, Cash, SS & Hsu, J 2016, 'Anterior temporal lobectomy for older adults with mesial temporal sclerosis', Epilepsy Research, vol. 127, pp. 358-365. https://doi.org/10.1016/j.eplepsyres.2016.09.021
Moura, Lidia M.V.R. ; Eskandar, Emad N. ; Hassan, Mursal ; Salinas, Joel ; Cole, Andrew J. ; Hoch, Daniel B. ; Cash, Sydney S. ; Hsu, John. / Anterior temporal lobectomy for older adults with mesial temporal sclerosis. In: Epilepsy Research. 2016 ; Vol. 127. pp. 358-365.
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abstract = "Objective To compare postoperative seizure-free survival between older and younger adults. Methods A retrospective cohort of 107 temporal lobe epilepsy patients with a diagnosis of mesial temporal sclerosis (MTS) received anterior temporal lobectomy (ATL) between 1993 and 2014. We divided the lower three quartiles (younger) and top quartile (older, all 47+ years) of patients, then reviewed patient registry and electronic medical records to determine time to first self-reported seizure after ATL, the primary outcome (mean = 3.5 years of follow-up, SD = 3.6). We also assessed Engel classifications, intraoperative and postoperative treatment complications, and social disability. We used Cox proportional hazard models to assess the association between individual traits and time of seizure recurrence. Results During follow-up, 35/107 (32.7{\%}) patients had post-operative seizure(s). After adjustment for potential confounders there were no significant differences in the probability of post-operative seizures between the older and younger groups, though we had limited precision (hazard ratio of 0.67 [0.28–1.59]), (p = 0.36). There were more treatment complications and disability in older patients (18{\%} vs. 1.3{\%} for any complications, 84.62{\%} vs. 58.23{\%} for driving disability, and 84.6{\%} vs. 60.7{\%} for work disability, p < 0.05). Conclusion Older patients appear to have more complications after ATL, compared with younger patients. Age, however, does not appear to have a large independent association with seizure recurrence.",
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N2 - Objective To compare postoperative seizure-free survival between older and younger adults. Methods A retrospective cohort of 107 temporal lobe epilepsy patients with a diagnosis of mesial temporal sclerosis (MTS) received anterior temporal lobectomy (ATL) between 1993 and 2014. We divided the lower three quartiles (younger) and top quartile (older, all 47+ years) of patients, then reviewed patient registry and electronic medical records to determine time to first self-reported seizure after ATL, the primary outcome (mean = 3.5 years of follow-up, SD = 3.6). We also assessed Engel classifications, intraoperative and postoperative treatment complications, and social disability. We used Cox proportional hazard models to assess the association between individual traits and time of seizure recurrence. Results During follow-up, 35/107 (32.7%) patients had post-operative seizure(s). After adjustment for potential confounders there were no significant differences in the probability of post-operative seizures between the older and younger groups, though we had limited precision (hazard ratio of 0.67 [0.28–1.59]), (p = 0.36). There were more treatment complications and disability in older patients (18% vs. 1.3% for any complications, 84.62% vs. 58.23% for driving disability, and 84.6% vs. 60.7% for work disability, p < 0.05). Conclusion Older patients appear to have more complications after ATL, compared with younger patients. Age, however, does not appear to have a large independent association with seizure recurrence.

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