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Use of Vagus Nerve Stimulator on Children With Primary Generalized Epilepsy
William P Welch1, Bilal Sitwat1, Yoshimi Sogawa1
11 Division of Pediatric Neurology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA.
Insights
Vagus nerve stimulator (VNS) therapy effectively reduced seizure frequency in neurotypical children with intractable primary generalized epilepsy. The VNS device was well-tolerated, with most patients experiencing significant seizure reduction.
Area of Science:
- Pediatric Neurology
- Epileptology
- Neurosurgery
Background:
- Primary generalized epilepsy in children can be medically intractable.
- Vagus nerve stimulation (VNS) is an established treatment for refractory epilepsy.
- Limited data exists on VNS outcomes in neurotypical children with primary generalized epilepsy.
Purpose of the Study:
- To evaluate the efficacy and tolerability of VNS in neurotypical children with medically intractable primary generalized epilepsy.
- To describe seizure frequency changes and complications associated with VNS implantation.
Main Methods:
- Retrospective chart review of 11 neurotypical children who underwent VNS surgery between 2011 and 2015.
- Analysis of seizure frequency before and after VNS implantation.
- Assessment of VNS-related complications.
Main Results:
- 64% of patients reported improved seizure frequency at 1-year follow-up.
- 55% of patients experienced fewer than 1 seizure per month post-VNS.
- 27% of patients had minor complications, with no device removals required.
Conclusions:
- Vagus nerve stimulator therapy is a well-tolerated and effective treatment option for reducing seizure frequency in neurotypical children with medically intractable primary generalized epilepsy.
- Seizure improvement was not dependent on specific VNS parameters or patient characteristics.
Objective:
To describe the response to vagus nerve stimulator (VNS) in otherwise neurotypical children with medically intractable primary generalized epilepsy.
Methods:
Retrospective chart review of patients who underwent vagus nerve stimulator surgery between January 2011 and December 2015.
Results:
Eleven patients were identified. Median follow-up duration was 2.5 years (1.2-8.4 years). Prior to vagus nerve stimulator surgery, all patients had at least 1 seizure per week, and 7/11 (64%) had daily seizures. At 1-year follow-up after vagus nerve stimulator, 7/11 (64%) reported improved seizure frequency and 6/11 (55%) reported fewer than 1 seizure per month. Three patients (27%) reported complications related to vagus nerve stimulator surgery, and no patients required device removal.
Significance:
In children with medically intractable primary generalized epilepsy, vagus nerve stimulator is well tolerated and appears to lead to improvement in seizure frequency. Improvement was not attributable to epilepsy classification, age at vagus nerve stimulator implantation, output current, duty cycle, or follow-up duration.
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