Predictors of vagus nerve stimulation complications among pediatric patients with drug-resistant epilepsy

Muthiah, Nallammai; Sharma, Nikhil; Vodovotz, Lena; White, George L.; Abel, Taylor J.

doi:10.3171/2022.6.peds2289

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…VNS also has a positive effect on epilepsy psychiatric comorbidity, including improvements in depression and overall mood ( 12 ). Side effects and complications of VNS are rare, with an incidence of less than 5%, and are usually related to the surgical intervention ( 13 ).…”

Section: Traditional Approaches: Vagus Nerve Stimulation and Corpus C...mentioning

confidence: 99%

The changing landscape of palliative epilepsy surgery for Lennox Gastaut Syndrome

Al-Ramadhani,

Hect,

Abel

2024

Front. Neurol.

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Lennox Gastaut Syndrome (LGS) is characterized by drug-resistant epilepsy that typically leads to decreased quality of life and deleterious neurodevelopmental comorbidities from medically refractory seizures. In recent years there has been a dramatic increase in the development and availability of novel treatment strategies for Lennox Gastaut Syndrome patient to improve seizure. Recent advances in neuromodulation and minimally invasive magnetic resonance guided laser interstitial thermal therapy (MRgLITT) have paved the way for new treatments strategies including deep brain stimulation (DBS), responsive neurostimulation (RNS), and MRgLITT corpus callosum ablation. These new strategies offer hope for children with drug-resistant generalized epilepsies, but important questions remain about the safety and effectiveness of these new approaches. In this review, we describe the opportunities presented by these new strategies and how each treatment strategy is currently being employed. Next, we will critically assess available evidence for these new approaches compared to traditional palliative epilepsy surgery approaches, such as vagus nerve stimulation (VNS) and open microsurgical corpus callosotomy (CC). Finally, we will describe future directions that would help define which of the available strategies should be employed and when.

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Section: Traditional Approaches: Vagus Nerve Stimulation and Corpus C...mentioning

confidence: 99%

The changing landscape of palliative epilepsy surgery for Lennox Gastaut Syndrome

Al-Ramadhani,

Hect,

Abel

2024

Front. Neurol.

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Vagal Nerve Stimulation in the Pediatric Population and Correlation between Family and Treatment Team Perspectives: Single-Center Experience

Alnaami,

Algarni,

Alqahtani

et al. 2024

J Neurol Surg A Cent Eur Neurosurg

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Background: Vagal nerve stimulation (VNS) is an adjunctive therapy to pharmacological treatment in patients with drug-resistant epilepsy. This study aimed to assess the efficacy of VNS therapy for seizure frequency reduction and improving quality of life (QOL) measures in children with refractory epilepsy and to evaluate the correlation between the perspectives of families and those of the treating team. Methods: This was a prospective cohort study conducted at Abha Maternity and Children’s Hospital, Saudi Arabia, from 2018 to 2022. A total of 21 pediatric patients who completed one year of follow-up after VNS implantation were included. Patients were aged between 2 and 14 years, with a mean age of 8.14 ± 3.92; 11 (52.4%) patients were female. Family and physician assessments were collected blinded to each other using Clinical Global Impression of Improvement (CGI-I) scores and QOL assessments to evaluate the correlation between the families’ and treating team’s perspectives on VNS outcomes. Results: In this study involving 21 patients with intractable epilepsy, VNS showed significant efficacy in reducing the frequency of seizures. VNS significantly reduced the number of seizures per week from a baseline median of 35 to a median of 0.25 at the end of the follow-up period, representing a dramatic reduction of 99.3% (p < 0.001). The number of emergency department visits per year decreased from a baseline median of 12 to a median of 2, a reduction of 83.3% (p < 0.001), whereas the number of hospital admissions per year decreased from a baseline median of 3 to a median of 1, a 66.7% decrease (p < 0.001). The number of antiepileptic medications taken decreased from a median of 4 to 3 (p < 0.001). Notably, 28.57% of the patients achieved complete seizure freedom, and 38% exhibited significant improvement, with at least 50% reduction in seizure frequency. Importantly, none of the patients experienced an escalation in seizure frequency following VNS treatment. The family and physician assessments showed varying degrees of alignment in perceptions, with “concentration” exhibiting a significant positive correlation (r = 0.498, p = 0.022), indicating noteworthy agreement, whereas verbal communication did not show a substantial correlation (r = −0.062, p = 0.791), indicating a divergence of views. Conclusion: VNS is a promising and well-tolerated therapy for individuals with intractable seizures, offering clinical benefits and potential enhancements in various aspects of QOL. The varying perceptions between family and physician assessments highlight the importance of considering multiple perspectives when evaluating treatment outcomes.

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Predictors of vagus nerve stimulation complications among pediatric patients with drug-resistant epilepsy

Cited by 2 publications

References 33 publications

The changing landscape of palliative epilepsy surgery for Lennox Gastaut Syndrome

The changing landscape of palliative epilepsy surgery for Lennox Gastaut Syndrome

Vagal Nerve Stimulation in the Pediatric Population and Correlation between Family and Treatment Team Perspectives: Single-Center Experience

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