An interictal EEG can predict the outcome of vagus nerve stimulation therapy for children with intractable epilepsy

Abstract

VNS is a well-tolerated and effective adjuvant therapy in pediatric patients with intractable epilepsy. Notably, patients with focal epileptiform discharges alone rather than those with generalized epileptiform discharges maybe better candidates for VNS.

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy

“…We analyzed age at seizure onset within each group in six studies [15,16,[18][19][20]24], including 416 patients; we found no significant difference between the good responders and poor responders (p = 0.530, SMD = 0.075, 95% CI: -0.159 to 0.310, heterogeneity test: Chi 2 = 7.44, p = 0.190, I 2 = 32.8%, Fig. 3).…”

“…At 6 m, 1, 2, 3, 4, 6 and 12 years after implantation, 33.99, 43.42, 46.50, 63.31, 52.71, 54.64, 70.37 and 82.90% of patients exhibited > 50% reduction of seizure frequency after VNS. In the 14 trials [7,[10][11][12][14][15][16][17][18][19][20][21][22]24], including a total of 906 participants, analysis age at VNS implantation as a predictor for VNS outcome within each group, we found no significant difference between the good responders and poor responders (p = 0.305, SMD = -0.075, 95% CI: -0.220 to 0.069; heterogeneity test: Chi 2 = 12.20, p = 0.526, I 2 = 0%, Fig. 2).…”

“…4). Four trials [13,15,20,22] included a total of 546 participants. We found no significant difference between the good responders and poor responders in seizure type (p = 0.113, RR = 0.784, 95% CI: 0.580-1.059; heterogeneity test: Chi 2 = 1.76, p = 0.624, I 2 = 0%, Fig.…”

“…However, the data about etiology contained zero, so we selected the statistical values of RD to calculate it and found no significant difference between the good responders and poor responders in etiology in nine studies [7,10,14,16,18,20,[22][23][24], including 697 patients (p = 0.187, RD = 0.063, 95% CI: -0.031 to 0.157; heterogeneity test: Chi 2 = 11.37, p = 0.182, I 2 = 29.6%, Fig. 6).…”

“…We included 16 studies [7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] in this meta-analysis. The population of several studies was pediatric patients with drug-resistant epilepsy [19][20][21][22]. Kossoff et al [21] analyzed patients for the predictor of the outcome with > 90% seizure reduction after VNS.…”