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Memory outcomes of temporal lobe surgery in adults aged over 45 years
Author(s) -
Tyrlíková Ivana,
Hummelová Zuzana,
Goldemundová Sabina,
Koriťáková Eva,
Nečasová Tereza,
Tyrlík Mojmír,
Brázdil Milan,
Chrastina Jan,
Hemza Jan,
Rektor Ivan
Publication year - 2021
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13427
Subject(s) - medicine , temporal lobe , epilepsy surgery , epilepsy , age groups , surgery , wechsler adult intelligence scale , hippocampal sclerosis , cognition , demography , psychiatry , sociology
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.