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Vagus nerve stimulation for drop attacks in a pediatric population.
Muhammad M Abd-El-Barr1, Jacob R Joseph, Rebecca Schultz
1Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.
Epilepsy & Behavior : E&B
|August 31, 2010
Summary
Vagus nerve stimulation (VNS) effectively reduced drop attack seizures in 46% of pediatric patients. Certain seizure types and EEG patterns predicted better outcomes for this epilepsy treatment.
Area of Science:
- Neurology
- Neurosurgery
- Pediatric Epilepsy
Background:
- Drop attack seizures are a debilitating form of epilepsy, often resistant to conventional treatments.
- Vagus nerve stimulation (VNS) is an established neuromodulatory therapy for refractory epilepsy.
Purpose of the Study:
- To evaluate the efficacy of vagus nerve stimulation (VNS) in pediatric patients with drop attack seizures.
- To identify pre-implantation characteristics that predict successful VNS outcomes.
Main Methods:
- Retrospective analysis of 43 pediatric patients with drop attack seizures treated with VNS.
- Assessment of seizure reduction and analysis of pre-implantation clinical and EEG data.
Main Results:
- 46% of patients achieved at least a 75% reduction in daily drop attacks.
- Atonic head nods and focal/lateralized epileptiform abnormalities on EEG were associated with better VNS response.
- No significant associations were found between other pre-implantation characteristics and VNS success.
Conclusions:
- Vagus nerve stimulation (VNS) provides significant palliative benefit for medically intractable drop attack seizures in children.
- Specific seizure semiologies and EEG findings may help select patients likely to benefit from VNS therapy.
