Neuropsychological Outcome in Older Patients Undergoing Anterior Temporal Lobectomy
Abstract number :
3.061
Submission category :
Year :
2001
Submission ID :
423
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
J.R. White, MD, MINCEP Epilepsy Care, Minneapolis, MN; T.S. Walczak, MD, MINCEP Epilepsy Care, Minneapolis, MN; C.M. Cox, MD, Neurosurgical Associates Ltd, Minneapolis, MN; R.C. Arndt, BS, MINCEP Epilepsy Care, Minneapolis, MN; I.E. Leppik, MD, MINCEP Epi
RATIONALE: The utilization of epilepsy surgery in patients older than 50 years has been limited in part due to concerns about increased memory loss post-operatively due to age.
METHODS: We reviewed anterior temporal lobectomy (ATL) epilepsy surgeries performed at MINCEP[reg] Epilepsy Care between 1/88 and 11/99 and selected patients older than 50 years at the time of surgery. For each index case we selected patients between 12 and 50 undergoing surgery just prior or just after the index case as controls. Patients were included in the study if they had ATL and had pre- and 6-8 month post-operative neuropsychological testing. Significant change in pre- vs. post-operative score was defined as greater than one standard deviation. Group differences between younger and older patients were analyzed using chi-square test.
RESULTS: Sixteen older patients (10 left ATL, 6 right ATL) and 29 younger patients (13 left ATL, 16 right ATL) met inclusion criteria. Mean age at surgery was 55.5 (range 50-72.8) for index cases and 33.0 (range 18.5-47.1) for controls. No significant differences were noted in pre-operative IQ scores between groups. Verbal memory outcome in older patients was as follows: 2 improved, 10 no change and 2 worsened (2 patients with incomplete data). Visual memory outcome in older patients was as follows: 4 improved, 11 no change, 1 worsened. No significant differences were noted in IQ, verbal or visual memory outcome between groups.
CONCLUSIONS: Older patients do not appear to be at increased risk of neuropsychologic decline after ATL when compared to younger patients. Our results support previous studies which indicate that ATL can be safe in selected patients older than 50.
Support: MINCEP[reg] Epilepsy Care and NIH-NINDS Grant P50 NS16308