Terapia con estimulación del nervio vago en pacientes con epilepsia fármaco-resistente y callosotomía previa

Benedetti-Isaac, Juan Carlos; Torres-Zambrano, Martín; Fandiño‐Franky, Jaime; Polo-Verbel, Luis Manuel; Bolaño-Esquirol, Margarita; Villa-Delgado, Rosmery; Guerra-Olivares, Randy; Alcalá-Cerra, Gabriel

doi:10.1016/j.neucir.2012.05.001

Cited by 3 publications

(7 citation statements)

References 16 publications

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“…In the literature, few patients (0-10%) become completely seizure free after callosotomy, although some seizure types are more favorable, especially those with drop attacks (tonic/atonic) [3,10,13,15,16,20,36,39], where seizure freedom from drop attacks is achieved in >60-80% of patients [4,8,12,13,20,24,40], or those with generalized tonic-clonic seizures, where seizure reduction is >50% [20]. A meta-analysis by Tellez-Zenteno et al [37 ]showed that >65% of patients with callosotomy experience a substantial reduction or complete elimination of disabling seizures [12,24,37].…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis by Tellez-Zenteno et al [37 ]showed that >65% of patients with callosotomy experience a substantial reduction or complete elimination of disabling seizures [12,24,37]. In other studies, Maehara and Shimizu [10], Oguni et al [41], and Sunaga et al [36] reported a ≥90% reduction in drop attacks in CC patients.…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies directly comparing these two procedures [1,30], and none is prospective or blinded, but the available evidence suggests that the two approaches have broadly similar palliative efficacies, although Nei et al [30] in a large comparison study for refractory generalized seizures conclude that there is a slightly greater efficacy but higher risk for complications associated with CC [1,12]. They reported that 79.5% of CC patients achieved at least 50% reduction in frequency of generalized tonic-clonic seizures; 60% of patients showed a reduction of at least 80%.…”

Section: Discussionmentioning

confidence: 99%

“…It is mostly used in patients with Lennox-Gastaut syndrome to reduce the number of disabling drop attacks [2,4,8,12,13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

“…Several authors have reported that the association of two palliative techniques such as CC and VNS provides good results in controlling seizures [12,24,30,31,32,33,34,35]. …”

Section: Introductionmentioning

confidence: 99%

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Combination of Corpus Callosotomy and Vagus Nerve Stimulation in the Treatment of Refractory Epilepsy

Guillamón

Miró²,

Gutiérrez³

et al. 2013

Eur Neurol

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Background: Palliative techniques such as partial corpus callosotomy (CC) and vagus nerve stimulation (VNS) may be effective for adequate control of seizures in pharmacoresistant patients who are not candidates for resective surgery. Objective: The objective of this study was to analyze the efficacy of the combination of these two techniques in patients where the first surgery had not achieved adequate control. Materials and Methods: This is a retrospective review of 6 patients with refractory epilepsy in which both types of surgery were performed, CC and VNS. We analyzed variables such as age, sex, age at onset of epilepsy, seizure types, electroencephalogram and magnetic resonance imaging results, and number of pre- and postoperative seizures. Results: Three patients first underwent VNS and then CC, and 3 patients were treated in reverse order. All patients had some improvement after the first surgery, but they continued to experience persistent falls, so a second palliative technique was used. The mean improvement after both surgeries was 89% (90% in patients first receiving CC and 87% in patients who first underwent VNS). Conclusions: In adequately studied patients who are not optimal candidates for resective surgery, palliative surgery is a choice. The combination of VNS and CC shows good results in our series, although the right order to perform both procedures has not been defined. These results should be confirmed in a larger group of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…It is mostly used in patients with Lennox-Gastaut syndrome to reduce the number of disabling drop attacks [2,4,8,12,13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

“…Several authors have reported that the association of two palliative techniques such as CC and VNS provides good results in controlling seizures [12,24,30,31,32,33,34,35]. …”

Section: Introductionmentioning

confidence: 99%

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