Vagus nerve stimulation for pediatric patients with drug-resistant epilepsy caused by genetic mutations: Two cases

Qin, Xiaoya; Lin, Sufang; Yuan, Yuan; Wen, Jialun; Chen, Qian; Lu, Xin; Sun, Yang; Wang, Fangping; Tian, Xinliang; Jiang, Ning; Liao, Jianxiang; Li, Luming

doi:10.26599/jnr.2020.9040014

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…It is generally acknowledged that epilepsy surgery and neuromodulation surgery are effective therapies to treat refractory epilepsy [3,4]. Recent studies have shown that neurostimulation has also become one of the effective therapies for refractory epilepsy [5,6].…”

Section: Introductionmentioning

confidence: 99%

Study on the relationship between obesity and complications of Pediatric Epilepsy surgery

et al. 2023

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Objective Studies have shown that obesity has a significant impact on poor surgical outcomes. However, the relationship between obesity and pediatric epilepsy surgery has not been reported. This study aimed to explore the relationship between obesity and complications of pediatric epilepsy surgery and the effect of obesity on the outcome of pediatric epilepsy surgery, and to provide a reference for weight management of children with epilepsy. Methods A single-center retrospective analysis of complications in children undergoing epilepsy surgery was conducted. Body mass index (BMI) percentiles were adjusted by age and used as a criterion for assessing obesity in children. According to the adjusted BMI value, the children were divided into the obese group (n = 16) and nonobese group (n = 20). The intraoperative blood loss, operation time, and postoperative fever were compared between the two groups. Results A total of 36 children were included in the study, including 20 girls and 16 boys. The mean age of the children was 8.0 years old, ranging from 0.8 to 16.9 years old. The mean BMI was 18.1 kg/m2, ranging from 12.4 kg/m2 to 28.3 kg/m2. Sixteen of them were overweight or obese (44.4%). Obesity was associated with higher intraoperative blood loss in children with epilepsy (p = 0.04), and there was no correlation between obesity and operation time (p = 0.21). Obese children had a greater risk of postoperative fever (56.3%) than nonobese children (55.0%), but this was statistically nonsignificant (p = 0.61). The long-term follow-up outcomes showed that 23 patients (63.9%) were seizure-free (Engel grade I), 6 patients (16.7%) had Engel grade II, and 7 patients (19.4%) had Engel grade III. There was no difference in long-term seizure control outcomes between obese and nonobese groups (p = 0.682). There were no permanent neurological complications after surgery. Conclusion Compared with nonobese children with epilepsy, obese children with epilepsy had a higher intraoperative blood loss. It is necessary to conduct early weight management of children with epilepsy as long as possible.

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Section: Introductionmentioning

confidence: 99%

Study on the relationship between obesity and complications of Pediatric Epilepsy surgery

et al. 2023

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“…VNS is a minimally invasive and controllable treatment for patients with epilepsy, and there are approximately 45%–65% responders (⩾50% reduction in seizure frequency) after VNS therapy. 8 – 12 In addition, indications, 13 – 15 safety, and side effects 16 , 17 of VNS therapy have been internationally validated and acknowledged. Some patient-related and epilepsy-related predictors with an impact on the prognosis of VNS therapy have been proposed.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and potential predictors of vagus nerve stimulation therapy in refractory postencephalitic epilepsy

Liu

Xiong

Wang

et al. 2022

Therapeutic Advances in Chronic Disease

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Background: Vagus nerve stimulation (VNS) is a therapeutic approach for patients with refractory postencephalitic epilepsy (PEE), which is characterized by drug resistance and disappointing surgical outcomes. However, the efficacy of VNS has not yet been studied in patients with refractory PEE. The present study aimed to demonstrate the efficacy of VNS and evaluate potential clinical predictors in patients with refractory PEE. Methods: We retrospectively collected the outcomes of VNS with at least a 1-year follow-up in all patients with refractory PEE. Subgroups were classified as responders and non-responders according to the efficacy of VNS (⩾50% or < 50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS responsiveness. Results: A total of 42 refractory PEE patients who underwent VNS therapy were enrolled, with an average age of 21.13 ± 9.70 years. Seizure frequency was reduced by more than 50% in 64.25% of patients, and 7.14% of patients achieved seizure-free events after VNS therapy. In addition, the response rates increased over time, with 40.5%, 50.0% and 57.1%, respectively at 6 months, 12 months, and 24 months after VNS therapy. Preoperative duration of epilepsy, monthly seizure frequency, and spatial distribution of interictal epileptic discharges (IEDs) were correlated with responders ( p < 0.05) in the univariate analysis. Further multivariate regression analysis demonstrated that refractory PEE patients with high monthly seizure frequency or Focal IEDs (focal or multifocal epileptiform discharges) achieved better efficacy on VNS ( p = 0.010, p = 0.003, respectively). Conclusion: VNS is an effective palliative therapy for patients with refractory PEE. Focal IEDs (focal or multifocal epileptiform discharges) and high seizure frequency were potential preoperative predictors of effectiveness after VNS therapy.

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Hybrid nanogenerator based closed-loop self-powered low-level vagus nerve stimulation system for atrial fibrillation treatment

et al. 2022

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Vagus nerve stimulation for pediatric patients with drug-resistant epilepsy caused by genetic mutations: Two cases

Cited by 4 publications

References 22 publications

Study on the relationship between obesity and complications of Pediatric Epilepsy surgery

Study on the relationship between obesity and complications of Pediatric Epilepsy surgery

Efficacy and potential predictors of vagus nerve stimulation therapy in refractory postencephalitic epilepsy

Hybrid nanogenerator based closed-loop self-powered low-level vagus nerve stimulation system for atrial fibrillation treatment

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