Vagus nerve stimulation in the treatment of drug-resistant epilepsy in 29 children.

Abstract

BACKGROUND/PURPOSE:

Vagus nerve stimulation (VNS) has been demonstrated to be safe and effective for adults and children with drug-resistant epilepsy and is able to improve most types of epilepsy. The aim of this study, in a paediatric population, was to assess the overall efficacy of vagus nerve stimulation on seizures, to assess tolerability and quality of life.

METHODS:

This single-centre, retrospective study reviewed the files of 29 children in whom a vagus nerve stimulator was implanted between 1995 and 2012. The response rate (greater than 50% reduction of the seizure frequency), antiepileptic efficacy according to the type of epilepsy or age at implantation or age at onset of epilepsy, the time-course of seizures, adverse effects, overall quality of life and number of hospitalisations were studied.

RESULTS:

In our population, vagus nerve stimulation achieved a significant reduction in the seizure frequency throughout follow-up (p = 0.015). Response rates were 59% at 3 months, and 66% at 6 months, and the response rate then remained stable at about 70%. Stimulation tended to be more effective in patients with non-idiopathic partial epilepsy than in patients with non-idiopathic and idiopathic generalised epilepsy (0.01 < p < 0.11). No other predictive factors of efficacy were identified. Patients, parents, caregivers reported improvement in overall quality of life in 38% of patients during clinical interviews. A significant reduction in the number of hospitalisations due to a reduction of seizure frequency was observed after implantation (p = 0.03). VNS was stopped because of complications or insufficient efficacy in 9 cases.

CONCLUSION:

Vagus nerve stimulation is a safe and effective treatment option in children with drug-resistant epilepsy who are not candidates for surgery.

• Authors: Emilie Bodin, Anne-Gaëlle Le Moing, Emilie Bourel-Ponchel, Laurent Querne, Patrick Toussaint, Patrick Berquin
• Journal: European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society (Eur J Paediatr Neurol) Vol. 20 Issue 3 Pg. 346-51 (May 2016) ISSN: 1532-2130 [Electronic] England
• PMID: 26922364 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Topics

• Adolescent
• Child
• Child, Preschool
• Drug Resistant Epilepsy (therapy)
• Female
• Humans
• Male
• Outcome Assessment, Health Care
• Retrospective Studies
• Vagus Nerve Stimulation (methods)