Early vagal nerve stimulator implantation in children: personal experience and review of the literature

Soleman, Jehuda; Knorr, Corine; Datta, Alexandre N.; Strozzi, Susi; Ramelli, Gian Paolo; Mariani, Luigi; Guzman, Raphael

doi:10.1007/s00381-017-3694-5

Cited by 17 publications

(11 citation statements)

References 18 publications

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“…Duration of epilepsy on the outcome of VNS between the responders and non-responders. responder rate, as well as short duration of epilepsy [14,27,[29][30][31], but Soleman et al thought age at implantation did not influence the responder rate [32], which agrees with our study. Those different results may be caused by the small samples of patients of those studies; thus, through systematically evaluating the literature, our study suggested that DRE patients with shorter duration of epilepsy may be better candidates for VNS and they are easier to help attain seizure reduction, rather than those who are younger at onset and implantation.…”

Section: Discussionsupporting

confidence: 91%

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy

Wang

Tan

Zhu

et al. 2019

Seizure

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A B S T R A C TPurpose: To evaluate the predictors of seizure reduction outcome after vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE). Methods: A meta-analysis was performed using relevant research from databases such as PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov. Studies were selected according to predefined inclusion and exclusion criteria. The quality of studies was evaluated by using the Newcastle-Ottawa Scale (NOS) scale. All data was pooled by STATA 12.0 software for meta-analysis. Results: The review considered 1281 articles, and 16 articles with NOS score ≥6 were included in the analysis. The meta-analysis showed that at 6 m, 1, 2, 3, 4, 6 and 12 years after implantation, 33.99, 43.42, 46.50, 63.31, 52.71, 54.64, 70.37 and 82.90% of patients exhibited > 50% reduction of seizure frequency after VNS. The duration of epilepsy showed a significant difference between the good responders and poor responders (p = 0.038), whereas age at VNS implantation (p = 0.305), age at seizure onset (p = 0.530), seizure type (p = 0.11), etiology (p = 0.187), and history of previous epilepsy surgery (p = 0.075) were not predictors of seizure reduction outcome after VNS. Several features about the electroencephalogram (EEG) feature and heart rhythm complexity (HRV) have not been analyzed by a sufficient number of studies. Conclusions: DRE patients with shorter duration of epilepsy may be better candidates for VNS rather than those who are younger at onset and implantation. Several EEG or HRV features may have predictive value but more research is needed.

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Section: Discussionsupporting

confidence: 91%

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy

Wang

Tan

Zhu

et al. 2019

Seizure

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“…Since the first operation in 1988, more than 100 000 VNS stimulators have been implanted around the world 3 . VNS has also been used for patients with various seizure types and epilepsy syndromes, including in children <4 years old 4 …”

Section: Introductionmentioning

confidence: 99%

“…As an adjunctive therapy, numerous studies have reported that VNS can effectively reduce seizure frequency 4 . After either two or three‐five years of stimulation, approximately 50% and 60% of epilepsy patients, respectively, were reported to achieve a ≥50% seizure reduction 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Altered amplitude of low‐frequency fluctuations and regional homogeneity in drug‐resistant epilepsy patients with vagal nerve stimulators under different current intensity

Zhu

et al. 2020

CNS Neurosci Ther

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Background The mechanisms of vagal nerve stimulation (VNS) for the treatment of drug‐resistant epilepsy (DRE) remain unclear. This study aimed to measure spontaneous brain activity changes caused by VNS in DRE patients using resting‐state functional MRI (rs‐fMRI). Methods The rs‐fMRI scans were performed in 16 DRE patients who underwent VNS surgery. Amplitude of low‐frequency fluctuations (ALFF) and regional homogeneity (ReHo) was generated and examined using paired sample t‐test to compare activity changes at different current intensity stage. The preoperative and postoperative ALFF/ReHo were also compared in eight responders (≥50% reduction of seizure frequency three months after surgery) and eight nonresponders using paired sample t‐test. Results The significant ALFF and ReHo changes were shown in various cortical/subcortical structures in patients under different current intensity. After three months of stimulation, responders exhibited increased ALFF in the right middle cingulate gyrus, left parahippocampal gyrus, and left cerebellum, and increased ReHo in the right postcentral gyrus, left precuneus, left postcentral gyrus, right superior parietal gyrus, right precentral gyrus, and right superior frontal gyrus. Nonresponders exhibited decreased ALFF in the left temporal lobe and right cerebellum, increased ALFF in bilateral brainstem, decreased ReHo in bilateral lingual gyri, and increased ReHo in the right middle frontal gyrus and right anterior cingulate gyrus. Conclusions The spontaneous neural activity changes in DRE patients caused by VNS were in an ongoing process. Increased ALFF/ReHo in frontal cortex, cingulate gyri, precentral/postcentral gyri, parahippocampal gyri, precuneus, parietal cortex, and cerebellum may implicate in VNS‐induced improvement in seizure frequency.

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“…Children with pharmacoresistant epilepsy are at a considerable risk of cognitive impairment, behavioral and mental health problems, and overall compromised quality of life [1][2][3]. Early seizure control in these patients is crucial.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and tolerability of perampanel in children and adolescents with pharmacoresistant epilepsy: The first real-world evaluation in Asian pediatric neurology clinics

Lin

Chou

et al. 2018

Epilepsy & Behavior

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Early vagal nerve stimulator implantation in children: personal experience and review of the literature

Cited by 17 publications

References 18 publications

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy

Altered amplitude of low‐frequency fluctuations and regional homogeneity in drug‐resistant epilepsy patients with vagal nerve stimulators under different current intensity

Efficacy and tolerability of perampanel in children and adolescents with pharmacoresistant epilepsy: The first real-world evaluation in Asian pediatric neurology clinics

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