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Surgery for focal epilepsy in the older patient

Departments of Neurology (Drs. Cascino, Sharbrough, and Hirschorn) and Neurosurgery (Dr. Marsh), Mayo Clinic and Mayo Foundation, Rochester, MN.

Eight of the 237 patients who received a surgical procedure for intractable partial epilepsy at the Mayo Clinic during a 3-year period were 50 years of age or older. All patients had disabling partial seizures of several years in duration that were refractory to anti epileptic drug medication. A neuroimaging-identified epileptogenic lesion prompted referral for surgical treatment in three patients. The only clinically significant morbidity associated with surgery in the eight patients was a transient exacerbation of an aphasia in a patient who underwent a left frontal corticectomy. All eight patients had a favorable seizure outcome, and three patients postoperatively are seizure free. Epilepsy surgery may be an appropriate alternate therapy for select patients in the sixth decade of life or older with medically refractory partial seizures.

Address correspondence and reprint requests to Dr. Gregory D. Cascino, 200 First Street, SW, Rochester, MN 55905.

Received November 21, 1990. Accepted for publication in final form February 13, 1991.

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