Long-term outcome after epilepsy surgery in older adults

Lang, Johannes; Grell, Laura; Hagge, Mareike; Onugoren, Müjgan Dogan; Gollwitzer, Stephanie; Graf, Wolfgang; Schwarz, Michael; Coras, Roland; Blümcke, Ingmar; Sommer, Björn; Rössler, Karl; Buchfelder, Michael; Schwab, Stefan; Stefan, Hermann; Hamer, Hajo M.

doi:10.1016/j.seizure.2018.02.012

Cited by 33 publications

(38 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This seizure outcome was almost equivalent to that of other studies and also equivalent to the younger adults in other studies. 8,22,23 As in our analysis, epilepsy surgery was equally effective in both younger and older patients, and older age did not preclude a favorable seizure outcome.…”

Section: Discussionsupporting

confidence: 68%

“…6,7 Similarly, elderly patients represent the most rapidly growing segment of the population with epilepsy. 8 Around 2000, the elderly started to exceed children in terms of the incidence of epilepsy, and today the elderly show the highest incidence. 9 Newonset epilepsies in the elderly are mostly seen as symptomatic focal epilepsy, which is likely to be amenable to epilepsy surgery.…”

Section: Introductionmentioning

confidence: 99%

“…9 Newonset epilepsies in the elderly are mostly seen as symptomatic focal epilepsy, which is likely to be amenable to epilepsy surgery. 8,10,11 The need for surgery for the elderly thus seems likely to be increasing over time. Although many elderly patients now live with epilepsy, very few centers are performing epilepsy surgery for the elderly.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

<p>Efficacy and Safety of Epilepsy Surgery for Older Adult Patients with Refractory Epilepsy</p>

Ichikawa¹,

Fujimoto²,

Okanishi³

et al. 2020

TCRM

View full text Add to dashboard Cite

The population of elderly patients with epilepsy has been growing rapidly and the chances of referring older patients with refractory epilepsy for surgical options could be increasing. In general, epilepsy surgery at higher ages has been less likely to be performed, because little is known regarding the risks and benefits in elderly patients. We, therefore, investigated surgical outcomes and comorbidities in a population ≥50 years old who underwent epilepsy surgery. Methods: Patients ≥50 years old who underwent epilepsy surgery were identified from the database of our epilepsy center for the period from 2009 to 2017. Surgical complications and seizure outcome were reviewed, and seizure outcomes were evaluated using the International League Against Epilepsy (ILAE) surgery outcome scale. Results: The mean age of 32 patients at the time of surgery was 56.1±5.1 years. The mean duration of epilepsy was 23.4±18.5 years and mean follow-up was 2.7±2.0 years. As of the most recent visit, 56.3% of patients remained completely seizure-free (ILAE Class I). The surgery-related complication rate was 11.5%, comprising permanent deficits in 3.8% and transient deficits in 7.7%. Conclusion: These results suggest that epilepsy surgery may represent a valuable approach in selected adult patients.

show abstract

Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Efficacy and Safety of Epilepsy Surgery for Older Adult Patients with Refractory Epilepsy</p>

Ichikawa¹,

Fujimoto²,

Okanishi³

et al. 2020

TCRM

View full text Add to dashboard Cite

show abstract

“…Epilepsy patients, who are scheduled for surgical treatment, are usually children or young adults without significant preoperative morbidities. However, the incidence of newly diagnosed drug-resistant epilepsy in elderly is increasing and due to the recent demographic development, the number of potential candidates for surgical treatment in this subgroup is rising as well [5].…”

Section: Introductionmentioning

confidence: 99%

“…The outcomes of epilepsy surgery in the elderly has been poorly investigated until now. Although some studies have shown similar epileptological outcome to younger patients [5,8], the investigated cohorts included heterogeneous population of patients with temporal and extratemporal epilepsy and present no data in respect of the postoperative quality of life.…”

Section: Introductionmentioning

confidence: 99%

Surgery for temporal lobe epilepsy in the elderly: Improving quality of life despite cognitive impairment

Delev

Taube

Helmstaedter

et al. 2020

Seizure

View full text Add to dashboard Cite

Introduction: Temporal lobe epilepsy (TLE) surgery is still underutilized, especially in the elderly population because of concerns related to postoperative complication rate and cognitive deterioration. The aim of the study was to evaluate surgical data, quality of life and neuropsychological outcome in elderly patients, who underwent resective surgery for drug resistant TLE. Methods and materials: All patients underwent standardized presurgical assessment including clinical, neuroradiological, neuropsychological, and EEG examination. Elderly were considered all patients being 50 years or above (mean 56 yr., range 50−71 yr.). Neuropsychology was assessed before and after surgery, health-related quality of life (HRQOL) only after surgery. Results: A total of 94 consecutive elderly patients were analyzed. Temporo-mesial resections were performed in 85 patients (90 %). Seizure outcome was available in all patients with a mean follow-up of 5.2 years (1.2−19 ± 3.75 years). 57 patients (60.6 %) were completely seizure free (ILAE 1). The overall morbidity was 10 % including 5 surgical complications and 5 permanent neurological deficits. Neuropsychological assessments in 60 patients showed considerable preoperative impairment, losses in different domains in 25-45 % and gains in about 25 % of the patients. Postoperative HRQOL data was available in 75 patients, revealing significant increase of HRQOL in all domains. Complete seizure freedom was the strongest predictor for postoperative HRQOL (p < 0.001). Conclusion: Surgery for drug resistant temporal lobe epilepsy is a feasible option for elderly patients as seizure control rates are comparable to the younger population. The acceptable rate of permanent neurological deficits and relevant improvements in quality of life, despite considerable postoperative cognitive impairment, justify surgical resection in properly selected elderly patients.

show abstract

Chronotype and sleep disorders in children with epilepsy

Özçelik

Karadağ

2023

Epileptic Disorders

View full text Add to dashboard Cite

The circadian rhythm can affect the frequency and resistance of epileptic seizures. In this cross-sectional study, we examined the impact of chronobiology and sleep disturbances on children with epilepsy. Methods: One hundred and twenty-five children and adolescents (55 patients and 70 controls) were included in the study. All participants were asked to complete the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Sleep Disturbances Scale for Children (SDSC), Childhood Chronotype Questionnaire (CCQ).Results: According to the CCQ results, controls had longer sleep duration (median 595 vs. 570), lower morningness-eveningness scores (median: 28 vs. 30), and higher rates of the morningness (12.9% vs. 1.8%) and intermediate (74.3% vs. 60%) chronotypes. The children and adolescents with epilepsy scored significantly higher in the Sleep breathing disorders (p = .001), Disorders of arousal nightmares (p = .044), Sleep-wake transition disorders (p = .037), Disorders of excessive somnolence (p = .001), and total SDCS (p = .046) scores. According to the RCADS-CV results, the children with epilepsy scored significantly higher in all subscales in comparison to controls (p < .05).

show abstract

Long-term outcome after epilepsy surgery in older adults

Cited by 33 publications

References 35 publications

<p>Efficacy and Safety of Epilepsy Surgery for Older Adult Patients with Refractory Epilepsy</p>

<p>Efficacy and Safety of Epilepsy Surgery for Older Adult Patients with Refractory Epilepsy</p>

Surgery for temporal lobe epilepsy in the elderly: Improving quality of life despite cognitive impairment

Chronotype and sleep disorders in children with epilepsy

Contact Info

Product

Resources

About