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Updated: Jan 11, 2026
Transauricular Vagus Nerve Stimulation and Electroencephalographic Assessment in Disorders of Consciousness
Published on: July 11, 2025
Vagus nerve stimulation for spike-and-wave activation in sleep in a pediatric patient: a case report
Chunyan Zhao1, Jiayi Ma1, Han Xie1
1Department of Pediatric Neurology, Children's Medical Center, Peking University First Hospital, Beijing, China.
Insights
Vagus nerve stimulation (VNS) effectively treated a young boy with epileptic encephalopathy with spike-and-wave activation in sleep (EE-SWAS), leading to seizure freedom and improved neurodevelopment. Early VNS intervention is recommended for children with EE-SWAS.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Neurostimulation
Background:
- Developmental and epileptic encephalopathy with spike-and-wave activation in sleep (DEE/EE-SWAS) presents significant challenges in pediatric epilepsy.
- Limited evidence exists on the efficacy of vagus nerve stimulation (VNS) for DEE/EE-SWAS, especially concerning its impact on spike-and-wave activation in sleep (SWAS).
Background:
Evidence regarding the efficacy of vagus nerve stimulation (VNS) in treating developmental and epileptic encephalopathy/ epileptic encephalopathy with spike-and-wave activation in sleep (DEE/EE-SWAS), particularly its impact on the SWAS remains limited. We present a boy with EE-SWAS who was treated with VNS at 4.8 years of age.
Case Presentation:
A male patient developed seizures at 2.3 years of age. At 2.8 years of age, electroencephalography (EEG) showed SWAS, leading to regression in cognitive, motor, and language functions. Administration of multiple anti-seizure medications (ASMs) achieved poor efficacy, and repeated corticosteroids resulted in only transient improvement. He was treated with VNS at 4.8 years of age. Seizure freedom was achieved at 1.3 years postoperatively. The SWAS pattern was not observed on follow-up EEG 2 years after implantation. Concurrently, his neurodevelopment improved. No new ASMs or corticosteroids were added during this period. VNS was interrupted due to pulse generator battery depletion at 5.6 years after implantation. Increased SWI was showed on the EEG 6 months after the interruption of stimulation.
Conclusion:
Early VNS intervention should be considered in addition to conventional medication for young children with SWAS who have greater distance from the self-limited age.
