Vagus nerve stimulation for drug-resistant epilepsy in children and young adults

Buoni, Sabrina; Mariottini, Aldo; Pieri, Sergio; Zalaffi, Alessandro; Farnetani, M. A.; Strambi, Mirella; Palma, Lucio; Fois, Alberto

doi:10.1016/s0387-7604(03)00120-7

Cited by 50 publications

(32 citation statements)

References 13 publications

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“…Therefore, preoperative low IQ should not be used to exclude patients as potential surgical candidates [12][13][14] . Resective surgery [11,14,15] , corpus callosotomy (CCT) [12,16,17] and vagus nerve stimulation [18,19] have been undertaken for these patients.…”

Section: Introductionmentioning

confidence: 99%

Anterior Corpus Callosotomy in Patients with Intractable Generalized Epilepsy and Mental Retardation

Liang¹,

Li²,

Jiang³

et al. 2010

Stereotact Funct Neurosurg

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Aims: To prospectively study outcomes of anterior corpus callosotomy (aCCT) in patients with refractory generalized epilepsy (RGE) and mental retardation (MR), and estimate the effect of preoperative Wechsler Full Scale Intelligence Quotient (FIQ) on surgical outcomes. Methods: Selected patients with RGE were divided into a moderate MR group (MoMR), mild MR group (MiMR) and no MR group (NMR), and all of them were treated with aCCT. Seizure outcomes were evaluated at the 1-year follow-up (1FU) and 2-year follow-up (2FU), and changes of quality of life (QOL) and IQ were tested at 2FU. Results: Seizure control did not differ by group or follow-up period. Most seizure reduction was achieved in atonic or tonic seizures with 76–80% reduction at 1FU and 81–87% at 2FU; myoclonic epilepsy was the least likely to respond. QOL changes differed among groups, and 53.2% of total patients showed postoperative QOL improvement: 75% in the MoMR group, 65% in the MiMR group and 21.1% in the NMR group. No significant group difference was seen in FIQ change, although average postoperative performance IQ (PIQ) improvement in patients with MR exceeded 4 points. Conclusion: aCCT can reduce seizures and is a safe surgical procedure. Low IQ does not affect seizure outcome and can be associated with a good surgical outcome in PIQ and QOL improvement.

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Section: Introductionmentioning

confidence: 99%

Anterior Corpus Callosotomy in Patients with Intractable Generalized Epilepsy and Mental Retardation

Liang¹,

Li²,

Jiang³

et al. 2010

Stereotact Funct Neurosurg

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“…Some studies [5,10] have already stated a reduction of seizure frequency of 50%, or more, and an improvement in the quality of life. Few side effects were reported due to VNS.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory effects induced by vagus nerve stimulation in epileptic children

Pruvost¹,

Zaaimi²,

Grebe³

et al. 2006

Med Bio Eng Comput

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Vagus nerve stimulation (VNS) is used in pharmaco-resistant epilepsy to decrease the number of seizures. Although it is well known that VNS affects respiration, there are only a few reports concerning an effect of VNS on heart rate or heart rate variability (HRV). We investigated the relationship between respiratory frequency and the high frequency (HF) domain of the discrete Fourier transform (DFT) of the RR interval function during night sleep recordings of ten subjects treated with VNS. Our results show that VNS shifts the frequency of maximal power spectrum density (PSD) in the HF-band, decreases the related PSD and induces a partial cardiorespiratory decoupling.

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“…Some studies report that 25-50% of patients with VNS achieve a 50% reduction in the number of seizures [2,8,9,48,49], but in other studies, this reduction is achieved in 50-75% of patients [8,9,50,51]. …”

Section: Discussionmentioning

confidence: 99%

“…CC was developed in the 1940s by van Wagenen and Herren, and has been widely used as palliative surgery for refractory epilepsy [7,8] in patients with acute intractable generalized seizures, drop attacks, refractory frontal lobe seizures or extensive unilateral hemispheric lesions [9,10,11] who are not candidates for focal resections. 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%

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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Vagus nerve stimulation for drug-resistant epilepsy in children and young adults

Cited by 50 publications

References 13 publications

Anterior Corpus Callosotomy in Patients with Intractable Generalized Epilepsy and Mental Retardation

Anterior Corpus Callosotomy in Patients with Intractable Generalized Epilepsy and Mental Retardation

Cardiorespiratory effects induced by vagus nerve stimulation in epileptic children

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

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