Vagus nerve stimulation for intractable epilepsy in children

Labar, Douglas

doi:10.1111/j.1469-8749.2000.tb00356.x

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…13 As regards patients with Lennox-Gastaut Syndrome, some studies indicate that VNS can produce satisfactory seizure control while others studies have failed to demonstrate significant efficacy. 7,8,11 Our results are consistent with the latter consideration.…”

Section: Discussionsupporting

confidence: 92%

“…In addition, the duration of the follow-up periods and changes in drug regimens are frequently not specified. [8][9][10][11][12]16,18 Our series includes two types of epileptic syndrome, i.e. Lennox-Gastaut Syndrome and partial epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…Results from small observational studies suggest that the therapeutic effect of VNS is better in children than in adults, and the benefit in children is achieved more rapidly. 1,3,6,[7][8][9][10][11][12][13][14][15][16][17] In a recent study on 60 children (mean age: 15 years), the median reduction in seizure frequency was 44%. 10 A retrospective study in six epilepsy centers evaluating the effectiveness of VNS therapy in 125 children with Lennox-Gastaut Syndrome (LGS), reported an average seizure reduction of 36.1% at 3 months and 44.7% at 6 months.…”

Section: Introductionmentioning

confidence: 99%

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Vagus nerve stimulation: Clinical experience in drug-resistant pediatric epileptic patients

Rychlicki

Zamponi

Trignani

et al. 2006

Seizure

102

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vagus nerve stimulation: Clinical experience in drug-resistant pediatric epileptic patients

Rychlicki

Zamponi

Trignani

et al. 2006

Seizure

102

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“…In the study of McLachlan, 16 AEDs were reduced in 43% of the patients, in the study of Qiabi, 10 only 9% of responders had lower antiepileptic medication at last follow-up compared with baseline and in other studies no changes on AEDs dose or number have been reported. 17,18 Finally there are some studies like the one from Labar et al 19 in which no changes of AEDs were done during the study, showing the benefit *Decrease and increase of medication doses in the same patient. ‡Decreased in the dose of medication were due to side effects in all cases.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Vagal Nerve Stimulation for Drug-Resistant Epilepsy: Is it the Stimulation or Medication?

Arcand

Waterhouse

Hernández-Ronquillo

et al. 2017

Can. J. Neurol. Sci.

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Background: Vagus nerve stimulation (VNS) therapy has been widely recognized as an alternative for the treatment of drug-resistant epilepsy, although modification of antiepileptic drugs (AEDs) during VNS treatment could explain the improvement in patients. Methods: We retrospectively assessed the efficacy of VNS in 30 adult patients with epilepsy treated with >6 months of follow-up. The criteria for implantation were the following: (1) not a candidate for resective epilepsy surgery, (2) drug-resistant epilepsy, (3) impairment of quality of life, (4) no other option of treatment, and (5) patients with idiopathic generalized epilepsy who fail to be controlled with appropriate AEDs. We assessed sociodemographics, seizure etiology, seizure classification, and AEDs used during treatment with VNS. We assessed adverse effects and efficacy. Responder rate was defined as >50% seizure improvement from baseline. Results: Thirty patients (females, 18; males, 12; age, 35.1 ± 13.3 years) were included. After 6, 12, 24, and 36 months of followup, the response rates were: 13/30 (43%), 13/27 (48%), 9/22 (41%), and 8/16 (50%), respectively; none was seizure free. Fifty-seven percent, 33%, 59%, and 81% of patients had changes of medication type or dose at 6, 12, 24, and 36 months respectively. In the majority of patients, the change of medication consisted of an increase in the dose of AEDs. Conclusions: Our study shows that VNS is an effective therapy, although significant changes in medications were done along with the therapy; therefore, the real effect of VNS could be controversial.RÉSUMÉ: Efficacité de la stimulation du nerf vague pour traiter l'épilepsie réfractaire. Contexte : La stimulation du nerf vague (SNV) est une alternative au traitement bien établi dans le traitement de l'épilepsie réfractaire, quoique la modification de la médication antiépileptique (MAE) pendant le traitement par SNV puisse expliquer l'amélioration constatée chez les patients. Méthodologie : Nous avons évalué rétrospectivement l'efficacité de la SNV chez 30 adultes atteints d'épilepsie traités par SNV et suivis pendant plus de 6 mois. Les critères pour l'implantation étaient les suivants : (1) ne pas être un candidat à la résection chirurgicale ; (2) être atteint d'une épilepsie réfractaire au traitement ; (3) présenter une altération de la qualité de vie ; (4) n'avoir aucune autre option de traitement et (5) être atteint d'épilepsie généralisée idiopathique qui n'est pas contrôlée par une MAE appropriée. Nous avons évalué les caractéristiques sociodémographiques, l'étiologie des crises, la classification des crises et la MAE utilisée pendant le traitement par la SNV. Nous en avons évalué les effets indésirables et l'efficacité. Le statut de répondeur a été défini comme étant un patient présentant une amélioration de plus de 50% des crises par rapport à la période précédant la SNV. Résultats : Trente patients (18 femmes et 12 hommes dont l'âge moyen était de 35,1 ± 13,3 ans) ont été inclus dans l'étude. Après un suivi de 6, 12, 24 et 36 ...

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“…Vagal nerve stimulation significantly reduces seizures frequency; but few patients become seizure free. It is safe and also effective in children [17,18]. Ketogenic diet is complicated and require extensive family commitment but extremely effective in seizure control.…”

Section: Discussionmentioning

confidence: 99%

Incidence and profile of intractable epilepsies in a pediatric neurology referral center

Rana

Singh

2015

J Pediatr Epilepsy

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A cross-sectional study was done in a pediatric neurology referral center over 2 yr. Our aim was to study the incidence and profile of intractable epilepsies. Children of either sex; presented with seizures were screened for intractability. Children with intractable seizures were further evaluated for intractability. Two hundred and sixty one children with seizures were identified as having intractable epilepsy. Pseudo-intractability was observed in 69% (non-epileptic events 35%, poor compliance, precipitating factors and surgical causes 24%, neurological symptoms wrongly diagnosed as seizures and pseudo seizures following true seizures in 9%). True medical intractability constituted 31%.

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Vagus nerve stimulation for intractable epilepsy in children

Cited by 9 publications

References 26 publications

Vagus nerve stimulation: Clinical experience in drug-resistant pediatric epileptic patients

Vagus nerve stimulation: Clinical experience in drug-resistant pediatric epileptic patients

Efficacy of Vagal Nerve Stimulation for Drug-Resistant Epilepsy: Is it the Stimulation or Medication?

Incidence and profile of intractable epilepsies in a pediatric neurology referral center

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