Programmed and Magnet-Induced Vagus Nerve Stimulation for Refractory Epilepsy

Boon, Paul; Vonck, Kristl; Walleghem, P. Van; D’Havé, M.; Goossens, Lutgard; Vandekerckhove, Tom; Caemaert, Jacques; Reuck, Jacques De

doi:10.1097/00004691-200109000-00003

Cited by 81 publications

(54 citation statements)

References 17 publications

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“…Positive effects of magnet activation have been previously described by different authors [29,39,[43][44][45]. In our series, magnet stimulation was useful (cessation of seizures or partial effect) in approximately two thirds of the patients and provided children and adolescents treated with VNS with an additional means of controlling their seizures.…”

Section: Discussionsupporting

confidence: 69%

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

Majkowska-Zwolińska¹,

Zwoliński

Roszkowski

et al. 2012

Childs Nerv Syst

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Section: Discussionsupporting

confidence: 69%

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

Majkowska-Zwolińska¹,

Zwoliński

Roszkowski

et al. 2012

Childs Nerv Syst

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“…However, response to active magnet use was associated with overall response to VNS treatment (χ 2 , p = 0.0479). In another Class III study 29 of 35 patients with partial epilepsy (mean age 30 years, range 10-49 years), 21 were able to self-administer or have a caregiver administer the magnet-activated stimulation and provide reliable magnet-use information. Of these 21, 14 (67%) were able to abort partial or secondary generalized seizures consistently.…”

Section: Clinical Contextmentioning

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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“…However, response to active magnet use was associated with overall response to VNS treatment (x 2 , p 5 0.0479). In another Class III study 29 of 35 patients with partial epilepsy (mean age 30 years, range 10-49 years), 21 were able to self-administer or have a caregiver administer the magnet-activated stimulation and provide reliable magnet-use information. Of these 21, 14 (67%) were able to abort partial or secondary generalized seizures consistently.…”

mentioning

confidence: 99%

Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy

Morris¹,

Gloss²,

Buchhalter³

et al. 2013

Neurology

354

203

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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 In 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 of age with partialonset seizures refractory to antiepileptic medications.1 A 1999 American Academy of Neurology (AAN) technology assessment concluded that VNS is indicated for patients .12 years with medically intractable partial seizures who are not candidates for potentially curative surgical resections such as lesionectomies or mesial temporal lobectomies. The authors also recommended that patients undergo a thorough epilepsy evaluation to rule out nonepileptic conditions or treatable symptomatic epilepsies before implantation of a vagus nerve stimulator. At that time, evidence was insufficient to recommend VNS for epilepsy in young children or for seizures associated with Lennox-Gastaut syndrome (LGS). Since the 1999 AAN assessment, the FDA has approved VNS for the adjunctive long-term treatment of chronic or recurrent depression in patients .18 years who are experiencing a major depressive episode and have not had an adequate response to 4 or more adequate antidepressant treatments.1 Moreover, there are new reports of long-term efficacy and VNS use in pediatric epilepsy and other seizure types and syndromes. We evaluated this evidence using the AAN guideline methodology.

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Programmed and Magnet-Induced Vagus Nerve Stimulation for Refractory Epilepsy

Cited by 81 publications

References 17 publications

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

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

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

Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy

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