Lidia M V R Moura1, Emad N Eskandar2, Mursal Hassan3, Joel Salinas3, Andrew J Cole3, Daniel B Hoch3, Sydney S Cash3, John Hsu4. 1. Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, United States. Electronic address: lidia.moura@mgh.harvard.edu. 2. Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, United States. 3. Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, United States. 4. Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA 02114, United States; Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, United States.
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=3.5years 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.
OBJECTIVE: To compare postoperative seizure-free survival between older and younger adults. METHODS: A retrospective cohort of 107 temporal lobe epilepsypatients 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=3.5years 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.
Authors: Anny Reyes; Erik Kaestner; Emily C Edmonds; Anna Christina Macari; Zhong Irene Wang; Daniel L Drane; Vineet Punia; Robyn M Busch; Bruce P Hermann; Carrie R McDonald Journal: Epilepsia Date: 2020-12-01 Impact factor: 5.864
Authors: Rick H G J van Lanen; M C Hoeberigs; N J C Bauer; R H L Haeren; G Hoogland; A Colon; C Piersma; J T A Dings; O E M G Schijns Journal: Acta Neurochir (Wien) Date: 2018-04-05 Impact factor: 2.216