Parenting stress in parents of children with refractory epilepsy before and after vagus nerve stimulation implantation

Li, Sung-Tse; Chiu, Nan-Chang; Kuo, Yung Ting; Shen, Ein‐Yiao; Tsai, Pei-Chieh; Ho, Che‐Sheng; Wu, Chin‐Chia; Chen, Juei-Chao; Wang, Chuanyu; Wang, Huei-Shyong; Lin, Kuang-Lin; Hung, Po-Cheng; Chang, Ying-Chao; Fan, Pi‐Chuan; Lee, Wang-Tso; Yang, Rei‐Cheng; Ko, Fang-Jong; Lin, Lung‐Chang; Chou, Po-Ching; Tsai, Jeng-Dau; Hung, Kun-Long; Chen, Hui-Ju; Chang, Kuo-Ting; Hsu, Ting-Rong; Chen, Shyi-Jou; Fan, Hueng-Chuen; Lee, Hsu‐Tung; Kuo, Huang-Tsung; Chang, Ming-Yuh; Chang, Ting-Wei; Yeh, Geng Chang

doi:10.1016/j.pedneo.2017.03.001

Cited by 13 publications

(10 citation statements)

References 38 publications

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“…25 Li et al enrolled 30 patients and found seizure reduction rate of 42.6%, and 15 patients (50%) had S50% seizure reduction rate, with one seizurefree patient (3.3%). 26 Although the studies of Tsai et al and Li et al aimed to investigate the impact of VNS on neuropsychological outcome in children with RE and parenting stress, their seizure reduction outcomes are consistent with our study.…”

Section: Discussionsupporting

confidence: 90%

Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan

Chiu

Hung

et al. 2020

Pediatrics & Neonatology

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Background: Vagus nerve stimulation (VNS) is used as an add-on treatment for epilepsy. This study aimed to use Taiwanese nationwide registry data to analyze the therapeutic effects of VNS in children with refractory epilepsy (RE) and try to explore predictive factors of VNS treatment effectiveness. Methods: This retrospective study collected data from December 2007 to December 2014. Patient variables included gender, age, VNS implantation date, epilepsy duration, seizure frequency, seizure type, etiology, and antiepileptic drug (AED) history. We divided patients into three groups: Group I as seizure frequency >80 times per month, Group II as seizure frequency 24e80 times per month, and Group III as seizure frequency <24 times per month. Multivariate regression analysis was performed to determine predictors of seizure frequency reduction after VNS treatment. Results: A total of 80 patients were included in this study. Three or more AED types were prescribed for 61 (77.1%) patients. Seizure frequency decreased significantly at 12 and 24 months

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Section: Discussionsupporting

confidence: 90%

Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan

Chiu

Hung

et al. 2020

Pediatrics & Neonatology

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“…The impact of VNS on QALY was assessed taking into account the following: the difference in the average utility score of QoL between the post-VNS period and the 6-months pre-VNS period; age; gender; and life expectancy in the entire VNS population [ 106 ]. VNS improved different health-related quality of life (HRQOL) domains—mainly cognitive, psychological, and social [ 92 , 107 , 108 , 109 ]—but it also improved memory, mood, behavior, alertness, achievement, and verbal skills [ 97 , 98 , 110 , 111 , 112 , 113 ].…”

Section: Resultsmentioning

confidence: 99%

Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

Marras

Colicchio

Palma

et al. 2020

IJERPH

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Background: Vagus nerve stimulation (VNS) is a palliative treatment for medical intractable epileptic syndromes not eligible for resective surgery. Health technology assessment (HTA) represents a modern approach to the analysis of technologies used for healthcare. The purpose of this study is to assess the clinical, organizational, financial, and economic impact of VNS therapy in drug-resistant epilepsies and to establish the congruity between costs incurred and health service reimbursement. Methods: The present study used an HTA approach. It is based on an extensive detailed bibliographic search on databases (Medline, Pubmed, Embase and Cochrane, sites of scientific societies and institutional sites). The HTA study includes the following issues: (a) social impact and costs of the disease; (b) VNS eligibility and clinical results; (c) quality of life (QoL) after VNS therapy; (d) economic impact and productivity regained after VNS; and (e) costs of VNS. Results: Literature data indicate VNS as an effective treatment with a potential positive impact on social aspects and on quality of life. The diagnosis-related group (DRG) financing, both on national and regional levels, does not cover the cost of the medical device. There was an evident insufficient coverage of the DRG compared to the full cost of implanting the device. Conclusions: VNS is a palliative treatment for reducing seizure frequency and intensity. Despite its economic cost, VNS should improve patients’ quality of life and reduce care needs.

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“…2 Meta-analysis results of effect size for corpus callosotomy. P = 0.000, I 2 = 83.8% satisfaction with VNS in generalized epilepsy [26]. Therefore, in selecting an appropriate initial surgical procedure for each child, individual family priorities with regard to most functionally limiting seizure type and expected functional outcome must be taken into account.…”

Section: Discussionmentioning

confidence: 99%

Atonic seizures in children: a meta-analysis comparing corpus callosotomy to vagus nerve stimulation

Mansouri

Warsi

et al. 2020

Childs Nerv Syst

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Purpose Atonic seizures are associated with a particularly poor response to medical treatment. We performed a systematic review and meta-analysis to compare the efficacy of corpus callosotomy (CC) and vagus nerve stimulation (VNS) in the management of atonic seizures in the pediatric population. Methods A literature search was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendations, focusing on atonic seizures, CC, and VNS in pediatric populations. Pertinent clinical data were extracted and analyzed. Pooled effects between groups were calculated as standardized error (SE) with 95% confidence intervals (CIs). To assess for statistical significance, the Z-test was performed, using the pooled effect size (ES) and 95% CI for each intervention. Results A total of 31 studies met the inclusion criteria, with 24 studies encompassing 425 children treated with CC and 7 studies encompassing 108 children treated with VNS. Twenty-four studies were included in a meta-analysis. There was a statistically significant difference in the primary outcome of atonic seizure control in favor of CC (overall effect size (ES) 0.73, 95% CI 0.69-0.77 for CC, ES 0.4, 95% CI 0.28-0.51 for VNS, p = 0.003). There was a higher rate of complications requiring reoperation in the CC cohort (6.6% vs. 3.8%) and a 14% rate of symptomatic disconnection syndrome. Conclusions While both techniques are safe, CC provides a much higher chance of effectively managing this morbid seizure type albeit with a higher risk of re-operation and disconnection syndrome.

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Parenting stress in parents of children with refractory epilepsy before and after vagus nerve stimulation implantation

Cited by 13 publications

References 38 publications

Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan

Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan

Health Technology Assessment Report on Vagus Nerve Stimulation in Drug-Resistant Epilepsy

Atonic seizures in children: a meta-analysis comparing corpus callosotomy to vagus nerve stimulation

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