Older adults who have epilepsy may fare better than expected in undergoing surgery to relieve seizures, according to a study by doctors in Grand Rapids and Detroit.
The findings could have a significant impact on older adults, who are at risk of developing seizures through head trauma, strokes, tumors and Alzheimers, the doctors say.
Traditionally, there has been a tendency to exclude older patients from surgery for fear of increased risk of medical or surgical complications, said Dr. Sanjay Patra, a Spectrum Health Medical Group neurosurgeon and lead author of the study. This study provides evidence that surgery may instead be a viable and effective treatment option.
The study compares results and complications of 122 surgical patients of Dr. Kost Elisevich, a neurosurgeon, and Dr. Brien Smith, a neurologist, from 1993 to 2008. They led the epilepsy center at Henry Ford Hospital in Detroit for 20 years before moving to Spectrum Health in Grand Rapids in 2011.
After surgery, those who became free of disabling seizures were: 58 percent of the under-50 group, 74 percent of those older than 50, and 91 percent of those 60 and older.
The older adults might have a high success rate because long-term experience with epilepsy can cause more changes in the brain and make it easier to locate the source of the seizures, said Smith, neurology chief of the Spectrum Health Medical Group.
The study also tracked post-surgery complications, such as nausea, depression, personality changes, headaches, and difficulty speaking and remember words. Complications occurred in about 14 percent of patients younger than 50 and 11 percent of those 50 and older.
However, verbal memory decline was greater in older adults and those who had epilepsy for more than 20 years. That could be attributed to less cognitive reserve in older adults, Smith said. Before undergoing surgery, patients memory function is tested and a neuropsychologist analyzes the risk of memory changes.
The results of the research are published online in the British Journal of Neurosurgery.
Smith noted that in about two-thirds of the cases, epilepsy is managed with medication. Surgery is considered as an option for those who dont respond to medication.
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Epilepsy surgery could be good option for older adults, study by Detroit, Grand Rapids doctors suggests