Vagus nerve stimulation in refractory epilepsy: New indications and outcome assessment

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• 作者：Carlo Efisio Marras ; Valentina Chiesa ; Aless ; ro De Benedictis ; Angelo Franzini ; Michele Rizzi ; Flavio Villani ; Francesca Ragona ; Laura Tassi ; Aglaia Vignoli ; Elena Freri ; Nicola Specchio ; Giovanni Broggi ; Marina Casazza ; Maria Paola Canevini
• 关键词：Vagus nerve stimulation ; Refractory epilepsy ; Palliative surgery
• 刊名：Epilepsy & Behavior
• 出版年：2013
• 出版时间：September, 2013
• 年：2013
• 卷：28
• 期：3
• 页码：374-378
• 全文大小：232 K

文摘

Although vagus nerve stimulation (VNS) is an effective alternative option for patients with refractory epilepsy unsuitable for conventional resective surgery, predictors of a better control of seizure frequency and severity are still unavailable. This prospective study reports on 39 patients, including 4 children affected by epilepsia partialis continua (EPC), who underwent VNS for refractory epilepsy. The overall seizure frequency outcome was classified into three groups according to reduction rate: ¡Ý 75 % , ¡Ý 50 % , and < 50 % . Engel and McHugh classifications were also used. The median follow-up period was 36 months. A seizure reduction rate ¡Ý 50 % or EPC improvement was observed in 74 % of the patients. Twenty-one out of 35 cases (60 % ) resulted in Engel classes II and III. Outcome, as defined by the McHugh scale, showed a responder rate of 71 % .

These results suggest that younger patient age and focal or multifocal epilepsy are related to a better seizure control and cognitive outcome. Vagus nerve stimulation could also be considered as an effective procedure in severe conditions, such as drug-refractory EPC.