TY - JOUR
T1 - Anterior temporal lobectomy for older adults with mesial temporal sclerosis
AU - Moura, Lidia M.V.R.
AU - Eskandar, Emad N.
AU - Hassan, Mursal
AU - Salinas, Joel
AU - Cole, Andrew J.
AU - Hoch, Daniel B.
AU - Cash, Sydney S.
AU - Hsu, John
N1 - Publisher Copyright:
© 2016 Elsevier B.V.
PY - 2016/11/1
Y1 - 2016/11/1
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.
AB - 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.
KW - Age
KW - Anterior temporal lobectomy
KW - Mesial temporal sclerosis
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U2 - 10.1016/j.eplepsyres.2016.09.021
DO - 10.1016/j.eplepsyres.2016.09.021
M3 - Article
C2 - 27760412
AN - SCOPUS:84991574371
SN - 0920-1211
VL - 127
SP - 358
EP - 365
JO - Epilepsy Research
JF - Epilepsy Research
ER -