Long-term results of vagus nerve stimulation in children and adolescents with drug-resistant epilepsy

Majkowska-Zwolińska, Beata; Zwoliński, Piotr; Roszkowski, Marcin; Drabik, Krzysztof

doi:10.1007/s00381-011-1670-z

Cited by 31 publications

(26 citation statements)

References 44 publications

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“…Sixteen Class III studies were identified regarding the efficacy of VNS for seizure treatment in children (see table e-1 for study details). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] This group of studies included 2 reports of patients with tuberous sclerosis 16,17 and one report of patients with Dravet syndrome. 18 Ten of 16 studies included subjects through age 18 18 One study of 11 patients with tuberous sclerosis had a mean age of 14, and the range of ages included was 2-35, with 2 subjects older than 19 (27 and 35).…”

Section: Analysis Of Evidencementioning

confidence: 99%

Evidence-Based Guideline Update: Vagus Nerve Stimulation for the Treatment of Epilepsy

et al. 2013

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Epilepsy Resources and UpdatesIn 1997, the US Food and Drug Administration (FDA) approved vagus nerve stimulation (VNS) as adjunctive therapy for reducing the frequency of seizures in patients >12 years with partial-onset seizures refractory to antiepileptic medications. OBJECTIVE: To evaluate the evidence since the 1999 assessment regarding efficacy and safety of vagus nerve stimulation (VNS) for epilepsy, currently approved as adjunctive therapy for partial-onset seizures in patients >12 years. METHODS: We reviewed the literature and identified relevant published studies. We classified these studies according to the American Academy of Neurology evidence-based methodology. RESULTS: VNS is associated with a >50% seizure reduction in 55% (95% confidence interval [CI] 50%-59%) of 470 children with partial or generalized epilepsy (13 Class III studies). VNS is associated with a >50% seizure reduction in 55% (95% CI 46%-64%) of 113 patients with Lennox-Gastaut syndrome (LGS) (4 Class III studies). VNS is associated with an increase in ≥50% seizure frequency reduction rates of ~7% from 1 to 5 years postimplantation (2 Class III studies). VNS is associated with a significant improvement in standard mood scales in 31 adults with epilepsy (2 Class III studies). Infection risk at the VNS implantation site in children is increased relative to that in adults (odds ratio 3.4, 95% CI 1.0-11.2). VNS is possibly effective for seizures (both partial and generalized) in children, for LGS-associated seizures, and for mood problems in adults with epilepsy. VNS may have improved efficacy over time. RECOMMENDATIONS: VNS may be considered for seizures in children, for LGS-associated seizures, and for improving mood in adults with epilepsy (Level C). VNS may be considered to have improved efficacy over time (Level C). Children should be carefully monitored for site infection after VNS implantation. Neurology® 2013;81:1-7 GLOSSARY: AAN = American Academy of Neurology; AE = adverse effect; BDI = Beck Depression Inventory; CI = confidence interval; FDA = US Food and Drug Administration; JME = juvenile myoclonic epilepsy; LGS = Lennox-Gastaut syndrome; SUDEP = sudden unexpected death in epilepsy; VNS = vagus nerve stimulation.

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Section: Analysis Of Evidencementioning

confidence: 99%

Evidence-Based Guideline Update: Vagus Nerve Stimulation for the Treatment of Epilepsy

et al. 2013

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“…[17,21] Other common adverse events of VNS, that were not present in our group of patients include bleeding and infection from the surgery, dyspnea, transitory hypotension, ventricular asystole, dyspnea, dyspepsia, dysphagia, vomiting, pharyngitis, headache and psychosis. Nearly two thirds of 57 patients in the study of MajkowskaZwolińska et al [7] experienced no adverse events specifically related to VNS. So we agree that this treatment is a safe option with minor side effects and injuries.…”

Section: Discussionmentioning

confidence: 91%

“…A slight decrease of antiepileptic drugs was reported in another study by Majkowska-Zwolińska et al [7] whereas no significant reduction after VNS implantation over one year follow up was stated by Elliott et al [20] The reduction in usage of antiepileptic drugs is very important from clinical point of view, since chronic use of these drugs may cause several side effects which contributes the impairment of quality of life in these patients.…”

Section: Discussionmentioning

confidence: 93%

“…Based on clinical observations, effects of treatment varies and VNS decreases the frequency and severity of seizure. [7,8] Here, in this study we investigated the effects of VNS treatment in patients with phamacoresistant epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…VNS therapy was approved in Europe in 1994 and by the US Food and Drug Administration in 1997 (data on file, Cyberonics, Inc., Houston , TX). [7,8] First VNS implantation was applied in 1998 in Turkey. [9] Currently used implantation conditions were determined by Social Insurance Institution in 2009.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Vagus Nerve Stimulation in Patients with Drug Resistant Epilepsy

Nalbantoğlu¹,

Özkara²,

Yeni³

et al. 2014

Epilepsi

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SummaryObjectives: Vagal nerve stimulation (VNS), is an adjunctive therapy approved for use in patients with refractory epilepsy, based on stimulation of the exctracranial part of the vagus nerve. In this study, we provide an analysis of seizure outcomes after VNS implantation for pharmacologically resistant epilepsy patients. Methods:We reviewed all patients who had VNS implantation in our center from 2005 to June 2013. Patient outcomes were evaluated using the VNS-specific outcome scale.Results: This study consisted of 35 patients (24 males, 11 females; mean age 13.7±8.2 years, range 7 to 40 years). The mean age at VNS implantation was 17.17±8.4 years (range 4 to 35 years). The mean duration of VNS therapy was 26±19.2 months (range 3 to 84 months). The 80% of our patients were in the responders, 20% of them were in the nonresponders group. Conclusion: Vagal nerve stimulation, is an alternative treatment approach. Given the potential for cognitive, behavioural improvement with or without improved seizure control, VNS may be considered in the course of treatment of refractory epilepsy.Key words: Refractory epilepsy; vagal nerve stimulation; VNS. ÖzetAmaç: Vagal sinir stimülasyonu (VNS), tedaviye dirençli epilepsi hastalarında uygulanan, vagal sinirin ekstrakraniyal bölümünün uyarımına dayanan, alternatif bir tedavi yöntemidir. Bu çalışmada, ilaç tedavisine dirençli olup VNS uygulanan hastalar gözden geçirilerek sonuçlar değerlendirildi. Gereç ve

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Vagus Nerve Stimulation for Intractable Seizures

Alonso-Vanegas

2013

Pharmacoresistance in Epilepsy

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Long-term results of vagus nerve stimulation in children and adolescents with drug-resistant epilepsy

Abstract: Vagus nerve stimulation therapy is a safe and effective adjunctive treatment for children and adolescents of all ages with drug-resistant epilepsy.

Cited by 31 publications

References 44 publications

Evidence-Based Guideline Update: Vagus Nerve Stimulation for the Treatment of Epilepsy

Evidence-Based Guideline Update: Vagus Nerve Stimulation for the Treatment of Epilepsy

Efficacy of Vagus Nerve Stimulation in Patients with Drug Resistant Epilepsy

Vagus Nerve Stimulation for Intractable Seizures

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