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Memory outcomes of temporal lobe surgery in adults aged over 45 years

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TYRLÍKOVÁ Ivana HUMMELOVÁ Zuzana GOLDEMUNDOVÁ Sabina KORIŤÁKOVÁ Eva NEČASOVÁ Tereza TYRLIK Mojmir BRÁZDIL Milan CHRASTINA Jan HEMZA Jan REKTOR Ivan

Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj Acta Neurologica Scandinavica
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://onlinelibrary.wiley.com/doi/epdf/10.1111/ane.13427
Doi http://dx.doi.org/10.1111/ane.13427
Klíčová slova epilepsy surgery; memory; older patients; temporal lobe epilepsy
Popis Objective It is assumed that temporal lobe resection in older people is associated with worse seizure outcomes and potential postsurgical memory decline. We studied postsurgical memory development and surgical efficacy in patients over 45 years of age compared with younger patients. Methods We studied 88 patients (51 male and 37 female) after temporal lobe surgery, which involved hippocampal resection. The patients were evaluated before surgery and in the first (72 patients) and/or third (57 patients) postsurgical year. The Wechsler Memory Scale III test was performed to evaluate the MQ postsurgical development. Engel's classification was used to evaluate the postsurgical seizure outcome. Results The presurgical MQ (median 88) in >= 45 years age group was significantly lower than in both younger groups (median MQ = 100 for <= 30 years age group, p = 0.002; median MQ = 107 for 31-44 years age group, p = 0.002). Three years after the surgery, the MQ decreased significantly in <= 30 years age group (p = 0.012), while only non-significant MQ decline was observed in both older groups. We found no significant impact of age on the surgical outcome. Conclusion Higher age at the time of surgery does not significantly increase the risk for postsurgical memory decline; however, older patients are more likely to have lowered presurgical MQ. We did not find significant differences in the impact of surgery on seizure outcome among the age groups. Epilepsy surgery appears to be a safe and effective method in the age over 45 years even though an earlier surgery should be preferred.
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