SURGERY FOR EPILEPSY: THE RIGHT AGE TO OPERATE

The age at which you have epilepsy surgery usually depends on the type of lesion you have. Obviously, if seizures are caused by a malignant tumour this will be removed, if possible, as soon as it is discovered. But if the surgery is only for epilepsy, there is no urgency; it can be done whenever it is convenient for you.
Most surgery involves lesions in the temporal lobe, and here the age at operation does seem to make a difference to its success. It used to be thought that there was no advantage in carrying out surgery early, and that it was better for the patient to wait until he or she was adult. But now it is believed that on the whole, the earlier temporal lobe surgery is carried out, the better. People who have the operation before puberty are more likely to be able to give up their drugs completely after it, and less likely to suffer any subsequent deterioration, so that they will have a more normal personality and be more independent. It is not yet known whether early operation is an advantage for people who have frontal lobe seizures but it is likely that it may be.
However, age is no barrier to operation, and here again, thinking has changed. Neurosurgeons used to believe that it was not advisable to perform temporal lobe surgery on anyone over 40. The view now taken is that one can operate up to almost any age, though the older the patient the more hazardous the operation becomes.
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