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Journal Articles Revue Neurologique Year : 2022

Predictive factors of postoperative outcome in the elderly after resective epilepsy surgery

Abstract

ABSTRACT Objective: To evaluate the efficiency of resective epilepsy surgery (RES) in patients over 50 years and determine prognostic factors. Results: Over the 147 patients over 50 years (54.9 ± 3.8 years [50-69]) coming from 8 specialized French centres for epilepsy surgery, 72.1%, patients were seizure-free and 91.2% had a good out- come 12 months after RES. Seizure freedom was not associated with the age at surgery or duration of epilepsy. In multivariate analysis, seizure freedom was associated with MRI and neuropathologi- cal hippocampal sclerosis (HS) (p = 0.009 and p = 0.028 respectively), PET hypometabolism (p = 0.013), temporal epilepsy (p = 0.01). On the contrary, the need for intracranial exploration was as- sociated with a poorer prognosis (p = 0.001). Postoperative number of antiepileptic drugs was sig- nificantly lower in the seizure-free group (p = 0.001). Neurological adverse event rate after surgery was 21.1% and 11.7% of patients had neuropsychological adverse effects overall transient. Conclusions: RES is effective procedure in the elderly. Even safe it remains at higher risk of com- plication and population should be carefully selected. Nevertheless, age should not be considered as a limiting factor, especially when good prognostic factors are identified.
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Dates and versions

hal-04533845 , version 1 (05-04-2024)

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Benjamin Thomas, Jérôme Aupy, Guillaume Penchet, M. de Montaudouin, Fabrice Bartolomei, et al.. Predictive factors of postoperative outcome in the elderly after resective epilepsy surgery. Revue Neurologique, 2022, 178 (6), pp.609-615. ⟨10.1016/j.neurol.2021.08.011⟩. ⟨hal-04533845⟩
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