Vagus Nerve Stimulation in Intractable Childhood Epilepsy: a Korean Multicenter Experience

Abstract

We evaluated the long-term outcome of vagus nerve stimulation (VNS) in 28 children with refractory epilepsy. Of these 28 children, 15 (53.6%) showed a >50% reduction in seizure frequency and 9 (32.1%) had a >75% reduction. When we compared seizure reduction rates according to seizure types (generalized vs. partial) and etiologies (symptomatic vs. cryptogenic), we found no significant differences. In addition, there was no correlation between the length of the stimulation period and treatment effect. The seizure reduction rate, however, tended to be inversely related to the seizure duration before VNS implantation and age at the time of VNS therapy. VNS also improved quality of life in this group of patients, including improved memory in 9 (32.1%), improved mood in 12 (42.9%), improved behavior in 11 (39.3%), improved altertness in 12 (42.9%), improved achievement in 6 (21.4%), and improved verbal skills in 8 (28.6%). Adverse events included hoarseness in 7 patients, dyspnea at sleep in 2 patients, and wound infection in 1 patient, but all were transient and successfully managed by careful follow-up and adjustment of parameters. These results indicate that VNS is a safe and effective alternative therapy for pediatric refractory epilepsy, without significant adverse events.

Effect of Vagus Nerve Stimulation in Post-Traumatic Epilepsy and Failed Epilepsy Surgery : Preliminary Report

“…Our findings suggest, however, that VNS is an effective treatment modality regardless of the type of seizure, semiology, type of previous epilepsy surgery, or etiology. You et al showed that VNS tended to be better tolerated and more effective in younger patients 13) . They also found that VNS resulted in a >50% reduction in seizure frequency in 53.6% of the children in their study and a >75% decrease in seizure frequency 6 months after VNS implantation 13) .…”

“…You et al showed that VNS tended to be better tolerated and more effective in younger patients 13) . They also found that VNS resulted in a >50% reduction in seizure frequency in 53.6% of the children in their study and a >75% decrease in seizure frequency 6 months after VNS implantation 13) . Our study shows that VNS implantation is also effective in adult patients.…”

Health-Related Quality of Life in Children and Adolescents with Epilepsy: A Systematic Review

“…In general, VNS improved different HRQOL domains in children and adolescents, mainly cognitive, psychological, and social (You et al, 2007;Sherman et al, 2008). However, there was no statistical difference between those children with and without VNS (You et al, 2007).…”

“…Three follow-up studies evaluated HRQOL in children and adolescents with implemented vagus nerve stimulation (VNS) (You et al, 2007;Sherman et al, 2008;Mikati et al, 2009). In general, VNS improved different HRQOL domains in children and adolescents, mainly cognitive, psychological, and social (You et al, 2007;Sherman et al, 2008).…”

Techniques and devices to restore cognition

“…In evaluating the effects vagal nerve stimulators have on patients who receive it to reduce seizure frequency, numerous investigators have coincidentally noticed a benefit on cognition [175]. In a study of ten epileptic participants implanted with vagus nerve stimulators, 2 min of stimulation at 0.50 mA 30 s after reading text was found to enhance subsequent word recognition [26].…”