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Effectiveness of vagus nerve stimulation in Dravet syndrome: a case series
Emily E Harford1, William P Welch2, Ruba Al-Ramadhani2
1Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA. harfordee@upmc.edu.
Purpose:
The purpose of this study is to report seizure outcomes for patients with Dravet syndrome (DS) who underwent vagus nerve stimulator (VNS) implantation at our center.
Methods:
We conducted a retrospective review of patients with DS who underwent VNS implant at UPMC Children's Hospital of Pittsburgh from 2005 to 2024 with at least 1 year of follow-up. Demographics and medical history related to epilepsy were collected at baseline. The primary outcome was response to VNS at 1 and 2 years post-VNS, defined as ≥ 50% reduction in seizure frequency compared to baseline. The number of anti-seizure medications (ASMs) and diet modification were also collected at 1 and 2 years post-VNS.
Results:
A total of 13 patients (69.2% female) with DS underwent VNS at a median age of 4.17 years (IQR, 2.58-4.58) and presented for follow-up at 1 (n = 13) and 2 (n = 9) years post-VNS. The response rate in our cohort was 61.5% (n = 8) at 1 year and 55.6% (n = 5) at 2 years post-VNS. Reduction in the number of ASMs was reported in a total of 7 (53.8%) patients, 4 of whom had reached the 2-year follow-up. Diet modification was attempted as a treatment strategy in 3 (23.1%) patients prior to VNS and maintained through 2 years post-VNS in 1 patient.
Conclusions:
VNS is associated with > 50% seizure frequency reduction in approximately 50% of patients with DS and may play a role in the multimodal treatment strategy employed for seizure control in these patients.
