Vagus nerve stimulation in children less than 3 years with medically intractable epilepsy

Area of Science:

• Pediatric Neurology
• Epilepsy Treatment
• Medical Devices

Background:

• Medically intractable epilepsy in children under three years presents significant challenges.
• Vagus Nerve Stimulator (VNS) therapy is an established treatment for epilepsy, but its efficacy in very young children requires further investigation.

Purpose of the Study:

• To characterize children under three years with medically intractable epilepsy who received Vagus Nerve Stimulator (VNS) therapy.
• To evaluate the effectiveness and safety of VNS in this specific pediatric population.

Main Methods:

• Retrospective chart review of patients treated between 2004 and 2011.
• Analysis of seizure frequency, etiology, MRI findings, and VNS complications.

Main Results:

• Fifteen patients with a median follow-up of 4.3 years were analyzed.
• Eighty percent had a known epilepsy etiology; 40% had a history of status epilepticus.
• Thirty-three percent showed improved seizure frequency at one year post-VNS; a normal MRI correlated with improvement (p=0.007).
• Status epilepticus frequency decreased post-VNS, and complications were infrequent (13%).

Conclusions:

• A normal MRI at VNS implantation predicted seizure improvement in children under three.
• VNS therapy demonstrated a modest overall seizure reduction but significantly decreased status epilepticus frequency.
• VNS was well-tolerated in this young pediatric cohort.