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Long-term vagus nerve stimulation in children with focal epilepsy
1Department of Child Neurology, Epilepsy Center Brno, Faculty of Medicine, Brno University Hospital, Masaryk University, Czech Republic. mryzi@seznam.cz
Insights
Vagus nerve stimulation (VNS) effectively reduces seizures and urgent hospitalizations in children with refractory focal epilepsy. This treatment significantly lowers both the frequency and duration of hospital stays, improving patient outcomes.
Area of Science:
- Pediatric Neurology
- Epileptology
- Neurosurgery
Background:
- Refractory focal epilepsy in children poses significant management challenges.
- Vagus nerve stimulation (VNS) is an established adjunctive therapy for epilepsy.
- Long-term data on VNS efficacy and hospitalization impact in pediatric refractory focal epilepsy are crucial.
Purpose of the Study:
- To evaluate the long-term efficacy of vagus nerve stimulation (VNS) in pediatric patients with refractory focal epilepsy.
- To assess the impact of VNS on hospitalization rates (frequency and duration) in this patient population.
Main Methods:
- Retrospective analysis of 15 children with intractable focal epilepsy treated with VNS.
- Assessment of seizure reduction and responder rates at 1, 2, and 5-year follow-ups.
- Comparison of urgent hospitalization frequency and duration pre- and post-VNS implantation.
Main Results:
- Significant seizure reduction observed: 42.5% at 1 year, 54.9% at 2 years, and 58.3% at 5 years.
- Responder rates increased from 46.7% at 1 year to 60% at 2 and 5 years.
- Mean urgent hospitalizations per patient decreased from 1.0 to 0.3 per year (P < 0.0001); mean hospitalization days reduced from 9.3 to 1.3 per year (P < 0.0001).
Conclusions:
- Vagus nerve stimulation (VNS) demonstrates sustained efficacy in managing refractory focal epilepsy in children.
- VNS therapy leads to a significant reduction in both the number and duration of urgent hospitalizations.
- VNS is a valuable therapeutic option for improving the quality of life for children with difficult-to-treat focal epilepsy.
Objectives:
The aim of the study was to evaluate the long-term efficacy and hospitalization rates in children with refractory focal epilepsy treated by vagus nerve stimulation.
Materials And Methods:
We retrospectively analyzed 15 children with intractable focal epilepsy treated by vagus nerve stimulation (mean age of 14.6 ± 2.5 years at the time of implantation). We analyzed the treatment effectiveness at 1, 2, and 5 year follow-up visits. We counted the average number of urgent hospitalizations and number of days of urgent hospitalization per year for each patient before and after the VNS implantation.
Results:
The mean seizure reduction was 42.5% at 1 year, 54.9% at 2 years, and 58.3% at 5 years. The number of responders was 7 (46.7%) at 1 year and 9 (60%) at both 2 and 5 years. The mean number of urgent hospitalizations per patient was 1.0 ± 0.6 per year preoperatively and 0.3 ± 0.5 per year post-operatively (P < 0.0001). The mean number of days of urgent hospitalization per patient was 9.3 ± 6.1 per year preoperatively and 1.3 ± 1.8 per year post-operatively ( < 0.0001).
Conclusions:
Vagus nerve stimulation is an effective method of treating children with refractory focal epilepsy. It leads to a substantial decrease in the number and duration of urgent hospitalizations.
