The role of vagus nerve stimulation in the treatment of refractory epilepsy: clinical outcomes and impact on quality of life

Martorell-Llobregat, Carlos; González-López, Pablo; Luna, E; Asensio-Asensio, M; Jadraque-Rodríguez, R; García-March, G.; Moreno-López, Pedro

doi:10.1016/j.nrleng.2019.04.004

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…The internal connections of the brain network are crucial for VNS ( 37 ), and longer seizure duration may lead to neuronal damage, causing patients to respond less to VNS than those with shorter seizure duration. Besides that, many studies have confirmed that seizure duration decreases after VNS, and a study by C Martorell-Llobregat showed that seizure duration was shorted after VNS in 88% of patients ( 38 ). We speculate that because VNS can reduce the duration of epileptic seizures, the benefits may be greater for patients with shorter duration.…”

Section: Discussionmentioning

confidence: 88%

Analysis of factors influencing the efficacy of vagus nerve stimulation for the treatment of drug-resistant epilepsy in children and prediction model for efficacy evaluation

Su,

Chang,

et al. 2024

Front. Neurol.

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ObjectiveVagus nerve stimulation (VNS) has been widely used in the treatment of drug-resistant epilepsy (DRE) in children. We aimed to explore the efficacy and safety of VNS, focusing on factors that can influence the efficacy of VNS, and construct a prediction model for the efficacy of VNS in the treatment of DRE children.MethodsRetrospectively analyzed 45 DRE children who underwent VNS at Qilu Hospital of Shandong University from June 2016 to November 2022. A ≥50% reduction in seizure frequency was defined as responder, logistic regression analyses were performed to analyze factors affecting the efficacy of VNS, and a predictive model was constructed. The predictive model was evaluated by receiver operating characteristic curve (ROC), calibration curves, and decision curve analyses (DCA).ResultsA total of 45 DRE children were included in this study, and the frequency of seizures was significantly reduced after VNS treatment, with 25 responders (55.6%), of whom 6 (13.3%) achieved seizure freedom. There was a significant improvement in the Quality of Life in Childhood Epilepsy Questionnaire (15.5%) and Seizure Severity Score (46.2%). 16 potential factors affecting the efficacy of VNS were included, and three statistically significant positive predictors were ultimately screened: shorter seizure duration, focal seizure, and absence of intellectual disability. We developed a nomogram for predicting the efficacy of VNS in the treatment of DRE children. The ROC curve confirmed that the predictive model has good diagnostic performance (AUC = 0.864, P < 0.05), and the nomogram can be further validated by bootstrapping for 1,000 repetitions, with a C-index of 0.837. Besides, this model showed good fitting and calibration and positive net benefits in decision curve analysis.ConclusionVNS is a safe and effective treatment for DRE children. We developed a predictive nomogram for the efficacy of VNS, which provides a basis for more accurate selection of VNS patients.

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Section: Discussionmentioning

confidence: 88%

Analysis of factors influencing the efficacy of vagus nerve stimulation for the treatment of drug-resistant epilepsy in children and prediction model for efficacy evaluation

Su,

Chang,

et al. 2024

Front. Neurol.

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“…Se evalúan luego de 5 vidas medias de uso medicamentoso para decidir falla farmacológica. Aunque la cirugía para epilepsia es conocida desde mediados del siglo XX, a inicios de los noventa se vio renovada por la colocación de neuroestimuladores vagales y por ablación de focos epileptógenos mejor definidos: amígdalohipocampectomía, callosotomía y transección subpial son las técnicas más comunes (13,14).…”

Section: Discussionunclassified

Procedimientos neuroquirúrgicos en parálisis cerebral. Estudio en 475 infantes, 1988-2018

2021

Gaceta Médica De Caracas

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Diversas patologías de manejo neuroquirúrgico pueden estar presentes entre niños y jóvenes con parálisis cerebral, lo cual puede interferir con las medidas terapéuticas físicas apropiadas, farmacológicas posibles o planes educativos adecuados a su problemática. Esta investigación tuvo como objetivo evidenciar, en infantes con parálisis cerebral, la presencia de diversas alteraciones susceptibles de ser tratadas mediante procedimientos propios de Neurocirugía, número y tipo de operaciones realizadas y causas por las cuales no se intervinieron los restantes.

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“…Tal terapia, no entanto, requer um olhar criterioso mediante sua É crucial ressaltar que a ENV não deve ser vista como uma solução isolada, mas sim como parte de uma abordagem multidisciplinar para o tratamento da epilepsia refratária (González et al, 2019). Por meio dessa terapia é possível, inclusive, reduzir a frequência, duração e gravidade das crises e do número de medicamentos antiepilépticos administrados (Martorell-Llobregat C et al, 2022).…”

Section: Neuroplasticidade E Estimulação Dounclassified

Neuroplasticidade e estimulação do Nervo Vago: Revisão Integrativa dos avanços no tratamento da Epilepsia.

Fernandes do Vale,

De Queiroz Cunha,

Cardoso Felipe

et al. 2023

Braz. J. Implantol. Health Sci.

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Introdução: A epilepsia refratária representa um desafio na neurologia, afetando a qualidade de vida dos pacientes que não respondem às terapias farmacológicas convencionais. A Estimulação do Nervo Vago (ENV) surge como uma abordagem promissora. Metodologia: Esta revisão integrativa foi baseada em 29 estudos sobre a ENV no tratamento da epilepsia refratária. Utilizou-se a estratégia PICO para a construção da pergunta de pesquisa e os artigos foram selecionados de bases de dados como MEDLINE/PubMed, Science Direct e LILACS. Resultados: A ENV mostrou-se eficaz na redução da frequência das crises epilépticas, com cerca de 8% dos pacientes alcançando liberdade de convulsões. Efeitos colaterais, como cefaleia e irritação da pele, foram leves e bem tolerados. A terapia foi especialmente benéfica para pacientes com síndromes epilépticas específicas. No entanto, o alto custo da ENV pode ser uma barreira para muitos pacientes. Conclusão: A ENV é uma abordagem segura e eficaz para o tratamento da epilepsia refratária. A intervenção precoce pode ser particularmente benéfica, especialmente em pacientes pediátricos. Futuras inovações tecnológicas podem tornar a ENV mais acessível e eficaz.

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The role of vagus nerve stimulation in the treatment of refractory epilepsy: clinical outcomes and impact on quality of life

Cited by 3 publications

References 18 publications

Analysis of factors influencing the efficacy of vagus nerve stimulation for the treatment of drug-resistant epilepsy in children and prediction model for efficacy evaluation

Analysis of factors influencing the efficacy of vagus nerve stimulation for the treatment of drug-resistant epilepsy in children and prediction model for efficacy evaluation

Procedimientos neuroquirúrgicos en parálisis cerebral. Estudio en 475 infantes, 1988-2018

Neuroplasticidade e estimulação do Nervo Vago: Revisão Integrativa dos avanços no tratamento da Epilepsia.

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