The efficacy of vagus nerve stimulation for epilepsy in Malaysia

S L Fong ¹, K S Lim ², A A Raymond ³

¹Universiti Malaya, Faculty of Medicine, Department of Medicine, Division of Neurology, Kuala Lumpur, Malaysia.
²Universiti Malaya, Faculty of Medicine, Department of Medicine, Division of Neurology, Kuala Lumpur, Malaysia. kslimum@gmail.com.
³Universiti Teknologi MARA (UiTM), Faculty of Medicine, Department of Medicine, Sungai Buloh, Malaysia.
⁴Universiti Kebangsaan Malaysia, Faculty of Medicine, Department of Medicine, Kuala Lumpur, Malaysia.
⁵Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Faculty of Medicine, Department of Medicine, Respiratory Unit, Kuala Lumpur, Malaysia.
⁶Hospital Tunku Azizah, Department of Paediatrics, Kuala Lumpur, Malaysia.
⁷Universiti Malaya, Faculty of Medicine, Department of Medicine and Paediatrics, Kuala Lumpur, Malaysia.
⁸Universiti Sains Malaysia, School of Medical Sciences, Department of Internal Medicine (Neurology), Kelantan, Malaysia.
⁹Universiti Sains Malaysia, School of Medical Sciences, Department of Neurosciences, Kelantan, Malaysia.
¹⁰Subang Jaya Medical Centre, Department of Medicine, Selangor, Malaysia.
¹¹Tunku Abdul Rahman Neuroscience Institute (IKTAR), Hospital Kuala Lumpur, Department of Neurosurgery, Malaysia.
¹²Tunku Abdul Rahman Neuroscience Institute (IKTAR), Hospital Kuala Lumpur, Department of Neurology, Malaysia.
¹³Hospital Sungai Buloh, Department of Medicine, Selangor, Malaysia.
¹⁴Hospital Raja Perempuan Zainab II, Department of Pediatric, Malaysia.
¹⁵LivaNova M Sdn Bhd, Kuala Lumpur, Malaysia.

⁰Universiti Malaya, Faculty of Medicine, Department of Medicine, Division of Neurology, Kuala Lumpur, Malaysia.

The Medical Journal of Malaysia +

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November 30, 2024

View abstract on PubMed

Summary

Vagus nerve stimulation (VNS) effectively reduces seizures in Malaysian patients with refractory epilepsy. Over 70% experienced significant seizure reduction at last follow-up, demonstrating VNS efficacy.

Area Of Science

Neurology
Epilepsy Research
Neurosurgery

Background

Vagus nerve stimulation (VNS) implantation in Malaysia began in 2000, with a significant increase in procedures since 2019.
VNS is utilized for epilepsy patients with persistent seizures post-surgery or those unsuitable for surgical intervention.

Purpose Of The Study

To evaluate the efficacy of vagus nerve stimulation (VNS) in a Malaysian cohort.
To analyze seizure reduction rates and identify factors influencing VNS effectiveness in refractory epilepsy.

Main Methods

Retrospective cross-sectional study of VNS procedures in Malaysia from January 2000 to December 2022.
Inclusion of DRE patients of all ages with at least one year of VNS follow-up data.

Main Results

63.3% of patients achieved ≥50% seizure reduction at one year, with 73.5% at last follow-up.
Optimal VNS parameters included current intensity ≥2mA (98.0%) and duty cycle ≥35% (81.6%).
No significant differences in response were observed based on age at implantation, epilepsy duration, or seizure type.

Conclusions

Vagus nerve stimulation (VNS) demonstrates significant efficacy in managing refractory epilepsy in Malaysia.
Approximately two-thirds of patients achieved substantial seizure reduction, highlighting VNS as a viable treatment option.