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Published on: January 7, 2019
[Vagus nerve stimulation therapy in patients with drug-resistant epilepsy and previous corpus callosotomy]
Juan Carlos Benedetti-Isaac1, Martín Torres-Zambrano, Jaime Fandiño-Franky
1Departamento de Investigación, Centro Latinoamericano de Investigación en Epilepsia-CLIE, Cartagena de Indias, Colombia.
Objective:
To analyse the results of vagus nerve stimulation in patients with drug-resistant epilepsy and previous corpus callosotomy.
Materials And Methods:
We prospectively reviewed data from patients with drug-resistant epilepsy who showed persistence of disabling seizures after undergoing corpus callosotomy, in whom it was not possible to identify an epileptogenic focus and who were subsequently treated with vagus nerve stimulation. Variables analysed included: age, gender, aetiology of epilepsy, frequency and characteristics of the crises and Engel scale classification, before and after vagal stimulator implant. Furthermore, the percentage differences in seizure frequency changes were also calculated.
Results:
Four patients were identified: two male and two female. The total seizure frequency had decreased between 20% and 81% after corpus callosotomy in three patients and one of them did not show any favourable response (Engel IVB). Following implantation of the stimulator they became reduced to between 57% and 100% after a mean follow-up period of 8.3 months (range: 3 to 12 months). Generalised seizures decreased between 71.4% and 100%, and focal seizures between 57.7% and 100%.
Conclusions:
Vagus nerve stimulation therapy proved to be an alternative for the reduction of seizure frequency in patients with drug-resistant epilepsy who suffered disabling seizures despite undergoing corpus callosotomy as primary surgery.
