关键词: 老年癫痫, 手术疗效, 并发症, 安全性

Abstract: Objective To investigate the seizure characteristics and the efficacy and safety of surgical treatment in older patients with epilepsy (≥60 years old).Methods The clinical data of 22 older patients with epilepsy who underwent surgical treatment from January 2013 to December 2021 in our epilepsy center were retrospectively analyzed,postoperative efficacy was assessed using Engel class,and surgery-related complications were followed up.Results 59.1% (13/22) of the22 older patients with epilepsy in this group had generalized tonic-clonic seizures,36.4% (8/22) of patients had a history of seizureclusters or status epilepticus.These 22 patients accounted for 1.6% (22/1392) of epilepsy surgeries in the same period,and surgery-related complications included:subcutaneous/subdural fluid in 4 cases,transient dysfunction in 2 cases,cerebral edema in 1 case and cerebral hemorrhage in 1 case.Histopathology included:brain tumor in 10 cases,gliosis in 4 cases,cerebrovascular disease in 2 cases,hippocampal sclerosis in 2 cases,focal cortical dysplasia in 2 cases,cerebral cysticercosis in 1 case,and unknown in 1 case.Three patients were lost to follow-up after surgery,three patients died due to tumor recurrence,and the remaining 16 patients were followed up for a mean of 35.1±19.9 months (12-84 months),with an outcome of 14 cases of Engel class I and 2 cases of Engel class II,and no permanent surgery-related complications occurred.Conclusion Older patients with epilepsy have ahigh risk from seizures and a large surgical treatment gap,and the postoperative outcome and safety of older patients with epilepsy screened for surgery through a comprehensive preoperative evaluation is good.

Key words: Older patients with epilepsy, Surgical outcome, Complications, Safety