Single-center long-term results of vagus nerve stimulation for pediatric epilepsy: a 10–17-year follow-up study

Chrastina, Jan; Horák, Ondřej; Ryzí, Michal; Brázdil, Milan; Novák, Zdeněk; Zeman, Tomáš; Danhofer, Pavlína

doi:10.1007/s00381-023-05992-3

Cited by 2 publications

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indications for VNS are drug-resistant epilepsy patients for whom curative surgery is difficult because the epileptic focus is difficult to detect or the epileptic focus is in an eloquent area. It is estimated that 45 to 65% of patients achieve at least a 50% reduction in seizure frequency by VNS (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Previous studies have reported a variety of good VNS response factors (1-10).…”

Section: Introductionmentioning

confidence: 99%

Effect of vagus nerve stimulation against generalized seizure and status epilepticus recurrence

Iimura,

Suzuki,

Mitsuhashi

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveVagus nerve stimulation (VNS) is a palliative surgery for drug-resistant epilepsy. The two objectives of this study were to (1) determine the seizure type most responsive to VNS and (2) investigate the preventive effect on status epilepticus (SE) recurrence.MethodsWe retrospectively reviewed 136 patients with drug-resistant epilepsy who underwent VNS implantation. We examined seizure outcomes at 6, 12, and 24 months following implantation of VNS as well as at the last visit to the Juntendo Epilepsy Center. Univariate analysis and multivariate logistic regression models were used to estimate the prognostic factors.Results125 patients were followed up for at least 1 year after VNS implantation. The percentage of patients with at least a 50% reduction in seizure frequency compared with prior to VNS implantation increased over time at 6, 12, and 24 months after VNS implantation: 28, 41, and 52%, respectively. Regarding overall seizure outcomes, 70 (56%) patients responded to VNS. Of the 40 patients with a history of SE prior to VNS implantation, 27 (67%) showed no recurrence of SE. The duration of epilepsy, history of SE prior to VNS implantation and seizure type were correlated with seizure outcomes after VNS implantation in univariate analysis (p = 0.05, p < 0.01, and p = 0.03, respectively). In multivariate logistic regression analysis, generalized seizure was associated with VNS response [odds ratio (OR): 4.18, 95% CI: 1.13–15.5, p = 0.03]. A history of SE prior to VNS implantation was associated with VNS non-responders [(OR): 0.221, 95% CI: 0.097–0.503, p < 0.01]. The duration of epilepsy, focal to bilateral tonic–clonic seizure and epileptic spasms were not significantly associated with VNS responders (p = 0.07, p = 0.71, and p = 0.11, respectively).ConclusionFollowing 125 patients with drug-resistant epilepsy for an average of 69 months, 56% showed at least 50% reduction in seizure frequency after VNS implantation. This study suggests that generalized seizure is the most responsive to VNS, and that VNS may reduce the risk of recurrence of SE. VNS was shown to be effective against generalized seizure and also may potentially influence the risk of further events of SE, two marker of disease treatment that can lead to improved quality of life.

show abstract