Long-term effect of vagus nerve stimulation on interictal epileptiform discharges in refractory epilepsy

Wang, Haiyang; Chen, Xiaoguang; Lin, Zhiguo; Shao, Zhengbo; Sun, Bomin; Shen, Hong; Liu, Li

doi:10.1016/j.jns.2009.04.012

Cited by 35 publications

(30 citation statements)

References 57 publications

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“…A weighted average of studies showed self-reported or caregiverreported benefit for 45% of the users, with seizure cessation in 28% (range 15-67%). Patients also reported decreased intensity or duration of seizures or lessening of the post-ictal period when using the Manual Magnet Mode (6,(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Automatic Vagus Nerve Stimulation Triggered by Ictal Tachycardia: Clinical Outcomes and Device Performance—The U.S. E-37 Trial

Fisher

Afra

Macken

et al. 2016

Neuromodulation: Technology at the Neural Interface

123

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ObjectivesThe Automatic Stimulation Mode (AutoStim) feature of the Model 106 Vagus Nerve Stimulation (VNS) Therapy System stimulates the left vagus nerve on detecting tachycardia. This study evaluates performance, safety of the AutoStim feature during a 3‐5‐day Epilepsy Monitoring Unit (EMU) stay and long‐ term clinical outcomes of the device stimulating in all modes.Materials and MethodsThe E‐37 protocol (NCT01846741) was a prospective, unblinded, U.S. multisite study of the AspireSR® in subjects with drug‐resistant partial onset seizures and history of ictal tachycardia. VNS Normal and Magnet Modes stimulation were present at all times except during the EMU stay. Outpatient visits at 3, 6, and 12 months tracked seizure frequency, severity, quality of life, and adverse events.ResultsTwenty implanted subjects (ages 21–69) experienced 89 seizures in the EMU. 28/38 (73.7%) of complex partial and secondarily generalized seizures exhibited ≥20% increase in heart rate change. 31/89 (34.8%) of seizures were treated by Automatic Stimulation on detection; 19/31 (61.3%) seizures ended during the stimulation with a median time from stimulation onset to seizure end of 35 sec. Mean duty cycle at six‐months increased from 11% to 16%. At 12 months, quality of life and seizure severity scores improved, and responder rate was 50%. Common adverse events were dysphonia (n = 7), convulsion (n = 6), and oropharyngeal pain (n = 3).ConclusionsThe Model 106 performed as intended in the study population, was well tolerated and associated with clinical improvement from baseline. The study design did not allow determination of which factors were responsible for improvements.

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Section: Introductionmentioning

confidence: 99%

Automatic Vagus Nerve Stimulation Triggered by Ictal Tachycardia: Clinical Outcomes and Device Performance—The U.S. E-37 Trial

Fisher

Afra

Macken

et al. 2016

Neuromodulation: Technology at the Neural Interface

123

View full text Add to dashboard Cite

show abstract

“…The few studies that used EEG recordings as an objective measurement are mostly in the interictal period [10,11]. In one study, an additional VNSstimulation by magnet activation appeared to promptly stop the ongoing seizure, as captured during a video-EEG-monitoring [12]. In our patient, none of the six seizures was terminated by the HRtriggered VNS-pulse, but significantly shortened.…”

Section: Discussionmentioning

confidence: 61%

Cardiac-based vagus nerve stimulation reduced seizure duration in a patient with refractory epilepsy

Hampel

Vatter

Elger

et al. 2015

Seizure

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“…The IEDR has been used as a neurophysiological marker, allowing quantifying the epileptiform activity. In deep brain stimulation [12,13] or vagal nerve stimulation [14,15,16,17,18], it has been shown that IEDR reduction is correlated with seizure frequency decrease. In the domain of temporal lobe surgery, Oliveira et al [19] intraoperatively compared IEDs before and after resection of the temporal pole and after resection of the mesial structures.…”

Section: Introductionmentioning

confidence: 99%

Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery

Tyrand

Momjian²,

Pollo

et al. 2016

Stereotact Funct Neurosurg

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Background/Aims: The monitoring of interictal epileptiform discharge rates (IEDRs) all along anterior temporal lobe resections (ATLRs) has never been reported. Here the effect of ATLR on continuous IEDR monitoring is described. Methods: IEDRs computed automatically during entire interventions were recorded in 34 patients (38.2%, 13/34 depth; 61.8%, 21/34 scalp electrodes only). Monitorings were invalidated when burst suppression occurred or if initial IEDRs were <5. Results: Monitoring was successful for 69.2% (9/13) of the patients with depth recordings and for 4.8% (1/21) of the patients with scalp recordings. Burst suppressions precluded it in 30.8% (4/13) of the depth and in 57.1% (12/21) of the scalp recordings. Initial IEDRs were <5 for 38.1% (8/21) of the scalp recordings. Significant IEDR decreases were observed in 8/10 patients with successful monitoring. These decreases started with resection of the superior temporal gyrus. IEDRs decreased further with amygdalohippocampectomy in 3/5 patients. At the 12-month follow-up, all patients with IEDR decreases remained seizure free; both patients without did not. Conclusion: IEDR monitoring was possible with depth, but not with scalp electrodes. IEDR decreases started with resection of the superior temporal gyrus. A larger patient cohort is necessary to confirm the high predictive values of IEDR monitoring that could become a tool for surgery customization.

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Long-term effect of vagus nerve stimulation on interictal epileptiform discharges in refractory epilepsy

Cited by 35 publications

References 57 publications

Automatic Vagus Nerve Stimulation Triggered by Ictal Tachycardia: Clinical Outcomes and Device Performance—The U.S. E-37 Trial

Automatic Vagus Nerve Stimulation Triggered by Ictal Tachycardia: Clinical Outcomes and Device Performance—The U.S. E-37 Trial

Cardiac-based vagus nerve stimulation reduced seizure duration in a patient with refractory epilepsy

Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery

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