title: Outcomes after resective epilepsy surgery in patients over 50 years of age in Sweden 1990-2009--a prospective longitudinal study.
abstract: OBJECTIVE
  Most epilepsy surgery candidates are young adults. Outcome reports after epilepsy surgery in patients ≥50 years are few and varying. The aim of this study was to describe patient characteristics of older compared to younger adults and analyse seizure, complication and vocational outcomes in a large population-based series.
  
  
  METHODS
  We analysed data from the Swedish National Epilepsy Surgery Register for 1990-2009 for patients ≥19 years at resective surgery who had completed two-year follow-up. Variables studied were seizure outcome, histo-pathological diagnoses, complications and vocational outcome. Data from patients ≥50 years and 19-49 years at surgery were compared.
  
  
  RESULTS
  558 Adults underwent resective epilepsy surgery 1990-2009 and had two-year follow-up. 12% of the adults (67 patients) were ≥50 years at surgery. Patients ≥50 had longer epilepsy duration, more often had mesial sclerosis and less often had neurodevelopmental tumours and cortical malformations. The proportion of seizure-free patients at two-year follow-up did not differ between those ≥50 and 19-49 years (61% versus 61% seizure-free last year, 48% versus 43% completely seizure-free since surgery), neither did the occurrence of major complications (3% in both groups). The vocational situation was mainly stable between baseline and two-year follow-up in both groups, although older patients were less often employed than younger.
  
  
  CONCLUSIONS
  12% of adults in the Swedish series were ≥50 years at epilepsy surgery. Seizure outcome was as good for older as for younger adults, and there was no difference in the occurrence of major complications. This constitutes important information in the presurgical counselling process.
authors.affiliation: Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. Electronic address: fatima.bialek@gmail.com.
authors.forename: Fatima
authors.initials: F
authors.lastname: Bialek
authors.affiliation: Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. Electronic address: Bertil.rydenhag@neuro.gu.se.
authors.forename: Bertil
authors.initials: B
authors.lastname: Rydenhag
authors.affiliation: Department of Clinical Neurophysiology, Akademiska University Hospital, Uppsala, Sweden. Electronic address: roland.flink@akademiska.se.
authors.forename: Roland
authors.initials: R
authors.lastname: Flink
authors.affiliation: Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. Electronic address: kristina.malmgren@neuro.gu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Malmgren
mesh_terms: D000328:Adult; D000367:Age Factors; D001921:Brain / Q000473:pathology / Q000601:surgery; D004651:Employment; D004827:Epilepsy / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011446:Prospective Studies; D012042:Registries; D013548:Sweden; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complications; Elderly; Epilepsy surgery; Seizure outcome