Analysis of the treatment of refractory epilepsy in pediatric patients with Vagus Nerve Stimulation (VNS): A case series

Jairo Porfírio de Oliveira Júnior ¹, Bárbara Albuquerque Morais ^2,3, Nayara Matos Pereira ³

⁰Division of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil. jairopoj@gmail.com.

Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery +

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December 16, 2025

View abstract on PubMed

Summary

Vagus nerve stimulation (VNS) significantly reduces seizures and improves quality of life in children with drug-resistant epilepsy (DRE). This safe neuromodulation therapy offers a valuable alternative for pediatric patients, decreasing hospitalizations and medication needs.

Area Of Science

Neurology
Pediatric Epilepsy
Medical Devices

Background

Drug-resistant epilepsy (DRE) affects up to 30% of pediatric patients, leading to significant morbidity and reduced quality of life.
Vagus nerve stimulation (VNS) is an alternative neuromodulation therapy for pediatric DRE patients unsuitable for surgery.
Limited evidence exists for VNS efficacy in pediatric populations, especially in resource-limited settings.

Purpose Of The Study

To evaluate the clinical outcomes of VNS in pediatric DRE patients.
To assess the safety and tolerability of VNS in this population.
To determine the impact of VNS on quality of life for children with DRE.

Main Methods

Retrospective observational study of 21 pediatric DRE patients who underwent VNS implantation.
Data collected on seizure frequency, hospitalizations, adverse events, medication use, and quality of life.
Seizure outcomes assessed using Engel and McHugh classifications.

Main Results

85.7% of patients achieved ≥50% seizure reduction; 76% reached McHugh Class I (> >80% reduction).
90.4% of caregivers reported improved quality of life (≥3/5 scale), with 47.6% giving the highest score.
Hospitalizations decreased in 87.5% of cases; 28% required fewer anti-seizure medications. Adverse events were mild and transient.

Conclusions

VNS is a safe and effective treatment for pediatric DRE, offering substantial seizure reduction and improved quality of life.
VNS therapy can decrease the burden of hospitalizations and medication requirements in children with DRE.
Further prospective studies are needed to optimize patient selection and VNS stimulation parameters.

Keywords:

Drug-resistant epilepsy Neuromodulation Pediatric epilepsy Quality of life Seizure outcome Vagus nerve stimulation