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Epilepsy Behav Case Rep. 2018 Sep 11;10:111-113. doi: 10.1016/j.ebcr.2018.08.002. eCollection 2018.

Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox-Gastaut syndrome.

Author information

1
Department of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC +, PO Box 61, 5591 VE Heeze, the Netherlands.
2
Department of Neurology, Maastricht UMC +, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands.
3
Department of Neurosurgery, Maastricht UMC +, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands.

Abstract

We report a child with Lennox-Gastaut syndrome with an increase in seizure frequency and loss of psychomotor skills due to a disintegrated cervical VNS lead, not detected during standard device monitoring. The lead was completely removed and replaced by a new 303 lead on the same nerve segment. After reinitiating VNS, side effects forced us to switch it off, resulting in immediate seizure recurrence. EEG recording demonstrated a non-convulsive status epilepticus that was halted by reinitiating VNS therapy. Thereafter, he remained seizure free for eight months, and regained psychomotor development.

KEYWORDS:

Lennox–Gastaut syndrome; Refractory epilepsy; Revision surgery; Seizure freedom; Vagus nerve stimulation

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