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Outcomes of vagal nerve stimulation in a pediatric population: a single center experience
Camilla Yu1, Sriram Ramgopal2, Mark Libenson3
1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Physiology, McGill University, Montreal, Quebec, Canada.
Insights
Vagus nerve stimulation (VNS) effectively reduced seizures in pediatric epilepsy patients, especially those with frequent seizures. This epilepsy treatment showed a median 50% seizure reduction at six months.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Epilepsy affects many children, often requiring multiple treatments.
- Medically refractory epilepsy presents significant challenges in pediatric care.
Purpose of the Study:
- To assess the effectiveness of vagus nerve stimulation (VNS) for pediatric epilepsy.
- To identify patient subgroups that benefit most from VNS therapy.
Main Methods:
- Retrospective review of 252 pediatric epilepsy patients undergoing VNS implantation.
- Analysis of 6- and 12-month follow-up data for 69 patients.
- Subgroup analysis based on seizure frequency, demographics, and epilepsy characteristics.
Main Results:
- Median seizure reduction of 50% at 6 months and 40% at 12 months.
- Significant seizure reduction (61% at 6 months, 69% at 12 months) in patients with high baseline seizure frequency.
- No significant reduction observed in patients with lower baseline seizure frequency.
Conclusions:
- Vagus nerve stimulation is an effective treatment for pediatric epilepsy.
- VNS demonstrates particular efficacy in children with high baseline seizure frequency.
- Adverse events occurred in 40.6% of patients, with some requiring VNS removal.
Objective:
To evaluate the efficacy of vagus nerve stimulation (VNS) in pediatric patients with medically refractory epilepsy.
Method:
We reviewed the medical records of 252 consecutive patients who underwent VNS implantation at a single center over a 5-year period. Patients with complete 6- and 12-month follow-up data were included. Analysis was also done across various subgroups including gender, age at implantation, seizure type, abnormal MRI findings pre-implantation, number of medications at baseline, history of SE, and duration of epilepsy.
Results:
Complete follow-up data were available for 69 patients. Median seizure reduction for these patients was 50% (Q1: 0%; Q3: 73%) at 6 months and 40% (Q1: -25%; Q3: 75%) at 12 months. When stratified by baseline seizure frequency, there was a significant reduction from baseline of 61% at 6 months and 69% at 12 months for patients in the high-baseline frequency group. There were no significant reductions at month 6 or 12 months for the lower-baseline frequency group. Adverse events were reported in 40.6% (28 out of 69 patients). Six patients had the VNS removed for reasons including lack of efficacy and side effects and were excluded from the study group.
Conclusion:
VNS provides significant seizure reduction, in particular in pediatric patients with a higher baseline seizure frequency.
