Epilepsy, surgery, and the elderly.
Treatment of elderly patients with epilepsy may present unique challenges to physicians. Co-morbid conditions and drugs to treat such conditions are common in elderly patients, possibly complicating epilepsy therapies that are dependent on drugs alone. For this reason, surgical intervention may be an attractive option for elderly patients with epilepsy, particularly for medically intractable patients with key disease features, such as lateralization and precisely localized epileptic foci. Curative procedures, including lobectomy and lesionectomy, are most likely to lead to seizure freedom, but not all patients are candidates for such procedures. When a curative surgical procedure is not an option, palliative procedures, including vagus nerve stimulation and deep brain stimulation, may be viable options. Vagus nerve stimulation has been reported to reduce seizure rates and improve quality of life in elderly patients with epilepsy. Currently, widespread therapeutic application of deep brain stimulation is limited by risks, costs, and pending studies.
Gallo
Bruno V
BV
Department of Neurology University of Miami, School of Medicine, 1501 NW 9th Ave., 2nd Floor, Miami, FL 33136, USA. bvgallo@aol.com
D000368:Aged; D046690:Deep Brain Stimulation; D004599:Electric Stimulation Therapy / Q000379:methods*; D004827:Epilepsy / Q000601:surgery* / Q000628:therapy; D006801:Humans; D014630:Vagus Nerve