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Seizure. 2014 Feb;23(2):105-11. doi: 10.1016/j.seizure.2013.10.002. Epub 2013 Oct 17.

Outcomes of vagal nerve stimulation in a pediatric population: a single center experience.

Author information

1
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Physiology, McGill University, Montreal, Quebec, Canada.
2
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, The Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
3
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.
4
Clinical Research Program, Boston Children's Hospital, Boston, MA, United States.
5
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Psychology, Emory University, Atlanta, GA, United States.
6
Department of Neurosurgery, Boston Children's Hospital, Boston, MA, United States.
7
Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States. Electronic address: tobias.loddenkemper@childrens.harvard.edu.

Abstract

OBJECTIVE:

To evaluate the efficacy of vagus nerve stimulation (VNS) in pediatric patients with medically refractory epilepsy.

METHOD:

We reviewed the medical records of 252 consecutive patients who underwent VNS implantation at a single center over a 5-year period. Patients with complete 6- and 12-month follow-up data were included. Analysis was also done across various subgroups including gender, age at implantation, seizure type, abnormal MRI findings pre-implantation, number of medications at baseline, history of SE, and duration of epilepsy.

RESULTS:

Complete follow-up data were available for 69 patients. Median seizure reduction for these patients was 50% (Q1: 0%; Q3: 73%) at 6 months and 40% (Q1: -25%; Q3: 75%) at 12 months. When stratified by baseline seizure frequency, there was a significant reduction from baseline of 61% at 6 months and 69% at 12 months for patients in the high-baseline frequency group. There were no significant reductions at month 6 or 12 months for the lower-baseline frequency group. Adverse events were reported in 40.6% (28 out of 69 patients). Six patients had the VNS removed for reasons including lack of efficacy and side effects and were excluded from the study group.

CONCLUSION:

VNS provides significant seizure reduction, in particular in pediatric patients with a higher baseline seizure frequency.

KEYWORDS:

Brain stimulation; Cranial Nerve; Efficacy; Epilepsy; Medically refractory epilepsy; Outcome; Pediatric; Seizure; Seizure control; Stimulation; Vagus nerve stimulation

PMID:
24309238
DOI:
10.1016/j.seizure.2013.10.002
[Indexed for MEDLINE]
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