The Neuropsychological Efficacy of Vagus Nerve Stimulation in 56 Children with Catastrophic Epilepsy

Abstract

Background:For children with catastrophic epilepsy, vagus nerve stimulation has been demonstrated as a palliative treatment for those with surgical contraindication. The purpose of our study was to assess the efficacy on seizures, to assess the neuropsychological efficacy of vagus nerve stimulation in children. Methods:Our study reviewed files of 56 children treated with vagus nerve stimulation between May, 2008 and December, 2013 in our center. Data was collected from baseline to 12, 24 months of follow-up, including seizure frequency, seizure duration, seizure severity and neuropsychological outcomes. Results:In the population of these 56 children, vagus nerve stimulation significantly reduced seizure frequency, duration and severity. The response rates (reduction >50%) were 46.4%, 57.2% at 12 months, 24 months. Furthermore, VNS also significantly achieved improvement of neuropsychological outcomes, particularly the language function of the children under 6 years. Conclusion:The children with catastrophic epilepsy, especially those under 6 years, could benefit from vagus nerve stimulation by reducing seizure burden and improving neuropsychological development.

The dual effect of vagus nerve stimulation in pediatric patients with drug-resistant epilepsy: Is there more than seizure control?

“…There is reason to believe that earlier treatment with non-pharmacological modalities will yield better cognitive functions in such children. Some reports in the literature addressed more improvement in cognitive domains in children < 6 years than those between the age of 6–14 years [51] . Other reports show no improvement of cognitive functions [52] .…”

Overexpression of Adenosine Kinase in Patients with Epilepsy Associated With Sturge-Weber Syndrome

“…In clinical practice, cognitive deficits, or mental retardation, may be considered as one of most common comorbidities of refractory epilepsy, especially for children [3,33]. Our recent study has demonstrated that vagus nerve stimulation (VNS) or deep brain stimulation (DBS) might improve neuropsychological outcomes, including language, memory, perception [34,35]. Consequently, we hypothesize that VNS or DBS may be an alternative treatment for SWS patients with refractory epilepsy, especially for those who cannot receive surgical resection.…”

The Present and Future of Vagus Nerve Stimulation

“…A 4-year follow-up after VNS showed a 60% rate of ≥50% seizure frequency reduction in a Korean study (mean age, 22.3 years; range, 8–44 years) [16]. Chinese colleagues retrospectively analyzed the effects of VNS on children (range, 1–14 years) and showed a 57.2% of patients experienced a ≥50% seizure frequency reduction [78]. A Japanese prospective study revealed a median seizure reduction of 66.2% after 3 years of VNS [42].…”