Short- and Long-Term Response of Vagus Nerve Stimulation Therapy in Drug-Resistant Epilepsy: A Systematic Review and Meta-Analysis

Mao, Hongliang; Chen, Yonghao; Ge, Qintao; Ye, Lei; Cheng, Hongwei

doi:10.1111/ner.13509

Cited by 18 publications

(26 citation statements)

References 76 publications

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“…Previous studies indicated that the responder rate of VNS for DRE was similar between adults and children (28,32) response to VNS therapy of 59 patients aged 4-6 years in a single center at 1, 2 and 4 years after VNS implantation was 55, 60, and 52%, respectively (27). These studies showed that the efficacy of VNS gradually increased and was basically stable after 2 years.…”

Section: Discussionmentioning

confidence: 66%

“…Previous studies indicated that the responder rate of VNS for DRE was similar between adults and children ( 28 , 32 ). Fang et al recently reported that the response rates of 213 children with DRE were 57.1, 69.2, and 70.7% at 12, 18, and 24 months, respectively ( 25 ).…”

Section: Discussionmentioning

confidence: 84%

“…Although several studies have observed that the effect of VNS on autistic behavior are independent of seizure control (21-23), within 2 years of VNS implantation, the proportion of pediatric DRE responders (≥50% reduction in seizure frequency) gradually increases from 20 to 60% (24)(25)(26)(27). Subsequently, the efficacy of VNS tends to stabilize (27)(28)(29). Whether the benefits of autistic behavior improvements are due to VNS or seizure control is still unclear.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Stable Vagus Nerve Stimulation Efficacy on Autistic Behaviors in Ten Pediatric Patients With Drug Resistant Epilepsy: An Observational Study

et al. 2022

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Vagus nerve stimulation (VNS) is a safe and effective therapy for pediatric patients with drug-resistant epilepsy (DRE). However, in children with DRE, the effects of VNS on autistic behaviors remain controversial. We retrospectively collected data from 10 children with DRE who underwent VNS implantation and regular parameter regulation in three pediatric epilepsy centers, and completed the behavioral assessments, including the autistic behavior checklist and the child behavior checklist, at follow-ups 1 (mean 2.16 years) and 2 (mean 2.98 years). The 10 children maintained stable seizure control between the two follow-ups. Their autistic behaviors, especially in language, social and self-help, were reduced at follow-up 2 compared to follow-up 1 (p = 0.01, p = 0.01, respectively). Moreover, these improvements were not associated with their seizure control, whether it was positive or negative. These results suggested that the VNS had a positive effect on autistic behaviors, which provided a preliminary clinical basis that VNS may benefit to younger children with DRE comorbidity autism spectrum disorder (ASD).

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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Effects of Stable Vagus Nerve Stimulation Efficacy on Autistic Behaviors in Ten Pediatric Patients With Drug Resistant Epilepsy: An Observational Study

et al. 2022

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“…VNS is a safe and effective neuromodulatory therapy for pediatric drug-resistant epilepsy, with a responder rate (> 50% seizure reduction) of around 35% to 50% after 2 years of follow up and higher rate after 5-year or longer follow-up [22,23]. In children, the responder rate is higher than that in adults with drug-resistant epilepsy with any etiology [24].…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of vagus nerve stimulation in drug-resistant KCNT1-related epilepsy: a case presentation

Wang

Geng

Meng

et al. 2022

Acta Epileptologica

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Background The KCNT1 gene encodes a Na+-activated K+ channel. Gain-of-function mutations of KCNT1 lead to autosomal dominant sleep-related hypermotor epilepsy, early-onset epileptic encephalopathy, focal epilepsy and other epileptic encephalopathies. In this paper, we report a boy carrying a KCNT1 gene mutation, who presented with drug-resistant focal-onset seizures. He had decreased seizure frequency and improvement of background changes in electroencephalography (EEG) after vagus nerve stimulation (VNS). Case presentation The case was a nonverbal 9-year-old male who presented with drug-resistant focal-onset seizures since age 3 and had underwent VNS therapy for 2 years. He had hypermotor symptoms, automatism and bilateral asymmetric tonic seizures with cognitive decline and aphasis from age 3. The patient had a variety of seizure types that only occurred at night. The most common seizure type was automatisms, and ictal video EEG showed high-amplitude delta waves, followed by a fast rhythmic sharp activity in the mesial frontal and bitemporal regions. The patient was diagnosed with KCNT1-related epilepsy, epileptic encephalopathy and cognitive disorder. He was refractory to multiple anti-seizure medicines (ASM) and ketogenic diet. After VNS treatment at age 7, the frequency of seizures was reduced significantly and EEG was improved in background slowing. Conclusions Children with KCNT1-related epilepsy usually have early onset of disease, are nonverbal, and are refractory to ASM. This boy with drug-resistant KCNT1-related epilepsy showed significantly reduced seizure frequency after VNS. This report may provide reference for management of cases of KCNT1-related epilepsy.

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“…In case of drug-resistant patients who cannot undergo or refuse surgical treatment of E, there are other ‘palliative’ therapeutic options available, between them neuromodulation (vagus nerve stimulation, deep brain stimulation, etc.) ( 16 ).…”

Section: Premisesmentioning

confidence: 99%

Governance of the clinical pathway and management of the patient suffering from epilepsy and drug-resistant epilepsy

Neve

Falcicchio

2022

Grhta

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Epilepsy is a diffuse chronic neurological disease affecting around 50 million people worldwide. The diagnostic criteria by the International League against Epilepsy must be fulfilled to diagnose the disease, which is characterized by brief and transient episodes of abnormal neuronal activity involving one or both hemispheres, depending on the epilepsy type. The diagnosis of epilepsy should be properly and timely made because patients suffering from the disease are affected not only by seizure recurrence but also by epilepsy-related psychiatric and/or cognitive comorbidities that may have a huge impact with severe professional and social implications. It is of vital importance to define a specific governance model that has to be virtuously applied into the different phases of the clinical pathway of the patients with epilepsy in order to guarantee them the best model of care possible.

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Short- and Long-Term Response of Vagus Nerve Stimulation Therapy in Drug-Resistant Epilepsy: A Systematic Review and Meta-Analysis

Cited by 18 publications

References 76 publications

Effects of Stable Vagus Nerve Stimulation Efficacy on Autistic Behaviors in Ten Pediatric Patients With Drug Resistant Epilepsy: An Observational Study

Effects of Stable Vagus Nerve Stimulation Efficacy on Autistic Behaviors in Ten Pediatric Patients With Drug Resistant Epilepsy: An Observational Study

Long-term follow-up of vagus nerve stimulation in drug-resistant KCNT1-related epilepsy: a case presentation

Governance of the clinical pathway and management of the patient suffering from epilepsy and drug-resistant epilepsy

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