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[Ten years' experience with vagus nerve stimulation in a paediatric population]
G Moro-De Faes1, B Serrano-Moyano1, V Cantarin-Extremera1
1Hospital Infantil Universitario Nino Jesus, 28009 Madrid, Espana.
Insights
The Vagus Nerve Stimulator (VNS) effectively reduces seizures in children with refractory epilepsy. This treatment also shows significant improvements in cognitive and behavioral aspects for pediatric patients.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Neurosurgery
Background:
- Epilepsy affects 50 million people globally, with up to 30% experiencing drug-resistant seizures.
- Vagus Nerve Stimulation (VNS) presents a viable therapeutic alternative for individuals with refractory epilepsy.
Purpose of the Study:
- To evaluate the efficacy of VNS in a cohort of pediatric patients diagnosed with refractory epilepsy.
- To assess the impact of VNS on seizure frequency and cognitive-behavioral outcomes in children.
Main Methods:
- Retrospective analysis of 35 pediatric patients who received VNS implantation between 2008 and 2017.
- Inclusion of epidemiological, etiological, clinical, and electrophysiological data, alongside VNS parameters.
Main Results:
- 43% of patients achieved a >= 50% reduction in seizures, with a mean reduction of 67.3%.
- Significant seizure reduction observed at 6 months (33%) and 24 months (47.4%).
- Notable cognitive (57%) and behavioral (53%) improvements were reported, with generally mild side effects (28%).
Conclusions:
- Vagus Nerve Stimulation is a valid treatment option for pediatric refractory epilepsy.
- VNS offers benefits beyond seizure control, positively impacting cognitive and behavioral functions in children.
- The VNS therapy demonstrates significant potential for improving the quality of life in pediatric epilepsy patients.
Introduction:
Fifty million people are affected by epilepsy. Up to 30% are not controlled with the aid of antiepileptic drugs. The vagus nerve stimulator (VNS) is a therapeutic alternative that must be taken into account.
Aims:
To determine the effect of the VNS in a cohort of paediatric patients with refractory epilepsy.
Patients And Methods:
A retrospective study of children with a VNS implanted between 2008 and 2017 in a tertiary hospital. Epidemiological, aetiological, clinical and electrophysiological data, along with VNS parameters were analysed.
Results:
The study included 35 patients, with a mean age when the VNS was implanted of 12.84 years (range: 3.1-18.7 years) and a mean time between onset of epilepsy and implantation of 7.2 years (range: 1.3-17.7 years). The causation was structural in 62.9% of cases. The most frequent epileptic conditions were: Lennox-Gastaut syndrome and focal epilepsy, with a predominance of tonic seizures (57.1%). The video electroencephalogram showed multifocal anomalies (54%) and a pattern of epileptic encephalopathies (34.3%). Intellectual disability was associated in 94% of the cases. The mean of previous antiepileptic drugs was 9.6 ± 3 (range: 4-16). 43% responded to treatment (>= 50% reduction in number of seizures), with a mean reduction of 67.3%, which improved with higher ages of onset of epilepsy. Three patients were seizure-free (8.5%). The number of seizures decreased by 33% at six months and by 47.4% at 24 months. There was also a notable degree of cognitive (57%) and behavioural improvement (53%). In 28% of cases there were some side effects, but in general they were mild.
Conclusions:
The VNS is a valid option in refractory epilepsy, with improvements not only in terms of seizures but also regarding cognitive-behavioural aspects, this being very important for the paediatric population.
