Vagal Nerve Stimulation for Drug-resistant Epilepsies in Different Age, Aetiology and Duration

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2010 Jan 22

PMID 20091042

Citations 23

Authors

Gabriella Colicchio

Domenico Policicchio

Giulia Barbati

Elisabetta Cesaroni

Filomena Fuggetta

Mario Meglio

Fabio Papacci

Franco Rychlicki

Massimo Scerrati

Nelia Zamponi

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of the study was to compare the outcome with respect to age of implant, aetiology and duration of epilepsy.

Methods: One hundred thirty-five drug-resistant epileptic patients, excluded from ablative surgery, were submitted to vagal nerve stimulation (1995-2007). Aetiology was cryptogenic in 57 and symptomatic in 78 patients. Ages of implant were 0.5-6 years (18 patients), 7-12 years (32 patients), 13-18 years (31 patients) and more than 18 years (54 patients). Epilepsy types were Lennox-Gastaut (18 patients), severe multifocal epilepsy (33 patients) and partial (84 patients). Duration of epilepsy is 3 months to 57 years. Clinical outcome was determined by comparing the seizure frequency after stimulation at 3-6-12-18-24-36 months with the previous 3 months. 'Responders' were the patients experiencing a seizure frequency reduction of 50% or more during follow-up. In statistical analysis, Wilcoxon and McNemar tests, general linear model for repeated measures, logistic regression and survival analysis were used.

Results: The seizure frequency reduction was significant in the group as a whole between baseline and the first follow-up (Wilcoxon test). The percentage of responder increases with time (McNemar test p = 0.04). Univariate analysis showed a significant effect of the age of implant on seizure frequency reduction: Adult patient had worst clinical outcome than children (p < 0.001) and adolescents (p = 0.08). Patients with severe multifocal epilepsy had better percentage seizure reduction compared with Lennox-Gastaut and partial (p = 0.03). Lesser duration of epilepsy had positive influence on outcome. Multivariate analysis confirmed age of implant to be the strongest factor influencing prognosis. Furthermore, positive is the association between lesional aetiology and young age.

Conclusions: The best responder could be a young lesional epileptic patient; after 3 years of follow-up, the percentage of responders is still in progress.

Citing Articles

Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy.

Patil A, Jayalakshmi S, Somayajula S, Shah D, Vooturi S, Panigrahi M Ann Indian Acad Neurol. 2025; 28(1):32-37.

PMID: 39951020 PMC: 11892970. DOI: 10.4103/aian.aian_389_24.

Vagus nerve stimulation for the therapy of Dravet syndrome: a systematic review and meta-analysis.

Chen S, Li M, Huang M Front Neurol. 2024; 15:1402989.

PMID: 39045432 PMC: 11263285. DOI: 10.3389/fneur.2024.1402989.

Neurostimulation treatments for epilepsy: Deep brain stimulation, responsive neurostimulation and vagus nerve stimulation.

Venetucci Gouveia F, Warsi N, Suresh H, Matin R, Ibrahim G Neurotherapeutics. 2024; 21(3):e00308.

PMID: 38177025 PMC: 11103217. DOI: 10.1016/j.neurot.2023.e00308.

Perianaesthetic management on a child with Lennox-Gastaut Syndrome for vagus nerve stimulation (VNS) placement.

Yeap T, Koo T, Ang S, Ab Mukmin L BMJ Case Rep. 2023; 16(11).

PMID: 38011949 PMC: 10685940. DOI: 10.1136/bcr-2023-255897.

Predictive factors for successful vagus nerve stimulation in patients with refractory epilepsy: real-life insights from a multicenter study.

Pires do Prado H, Pinto L, Bezerra D, de Paola L, Arruda F, de Oliveira A Front Neurosci. 2023; 17:1210221.

PMID: 37575303 PMC: 10413387. DOI: 10.3389/fnins.2023.1210221.

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