DELAYED EFFECT OF VNS ON INTERICTAL EPILEPTIFORM DISCHARGES AND PHARMACORESISTANCE IN A PATIENT WITH REFRACTORY
Davor Sporiš1, Silvio Bašić1, Darko Chudy1
11Department of Neurology, Dubrava University Hospital, Zagreb, Croatia; 2Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia; 3Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4University of Applied Health Science in Zagreb, Zagreb, Croatia.
Abstract:
A 20-year-old female with refractory perinatal postischemic catastrophic epilepsy and frequent daily generalized atonic, tonic, tonic-clonic and focal seizures was hospitalized in the progressive phase of illness. The diagnosis was confirmed by semiology, interictal electroencephalogram (EEG), long-term video EEG monitoring, and brain magnetic resonance imaging. Repeated interictal EEG findings showed generalized spike and slow wave complexes with a 2-3 Hz frequency. Interictal EEG showed evidence of electroclinical epileptic status on several occasions. She was treated with various antiepileptic drugs without improvement. After verification of her incompetence for normal autonomous living, which resulted in very low quality of life, this patient with refractory epilepsy underwent implantation of vagus nerve stimulator (VNS). In this case report, we present delayed effect of VNS on interictal epileptiform discharges and pharmacoresistance.
