Vagus Nerve Stimulation for Refractory Epilepsy: A Transatlantic Experience

Vonck, Kristl; Thadani, Vijay M.; Gilbert, Karen; Dedeurwaerdere, Stefanie; Groote, Liesbeth De; Herdt, Veerle De; Goossens, Lut; Gossiaux, Fleur; Achten, Erik; Thiery, Evert; Vingerhoets, Guy; Roost, Dirk Van; Caemaert, Jacques; Reuck, Jacques De; Roberts, David W.; Williamson, Pétér D.; Boon, Paul

doi:10.1097/01.wnp.0000139654.32974.4e

Cited by 112 publications

(60 citation statements)

References 31 publications

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“…At a mean follow-up duration of 33 months, they reported a mean reduction of 55% in seizures of the patients. The results were similar in adolescents and children who were under 13 years (36). Elliot et al analyzed 436 patients and inspected that seizure control ≥90% was achieved in 90 patients (22.5%), ≥75% seizure control in 162 patients (40.5%), ≥50% improvement in 255 patients (63.75%), and 50% improvement in 145 patients (36.25%) (12,13).…”

Section: Degiorgio Et Al Investigated 195 Patients With Generalizedmentioning

confidence: 63%

Vagal nerve stimulation effects on generalized-partial seizures and medication in adult drug resistans epilepsy patients

Özdoğan

Nurhat²,

Düzkalır³

et al. 2013

Turkish Neurosurgery

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Section: Degiorgio Et Al Investigated 195 Patients With Generalizedmentioning

confidence: 63%

Vagal nerve stimulation effects on generalized-partial seizures and medication in adult drug resistans epilepsy patients

Özdoğan

Nurhat²,

Düzkalır³

et al. 2013

Turkish Neurosurgery

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“…Others have reported vocal cord paralysis in 1%-5.6% of patients. 7,17,21,23,32,34,37,38,41 The surgical complication rate for all procedures was 8.6%, and 1.4% of the patients experienced vocal cord paralysis and all recovered completely. In a recent study by Robinson and Winston, 33 vocal cord paralysis occurred at almost twice the rate with leads that had a 2-mm inner diameter in comparison with 3-mm inner diameter in patients 18 years of age and older.…”

Section: Discussionmentioning

confidence: 99%

Complications and safety of vagus nerve stimulation: 25 years of experience at a single center

Révész

Rydenhag

Ben‐Menachem

2016

PED

132

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OBJECTIVE The goal of this paper was to investigate surgical and hardware complications in a longitudinal retrospective study. METHODS The authors of this registry study analyzed the surgical and hardware complications in 247 patients who underwent the implantation of a vagus nerve stimulation (VNS) device between 1990 and 2014. The mean follow-up time was 12 years. RESULTS In total, 497 procedures were performed for 247 primary VNS implantations. Complications related to surgery occurred in 8.6% of all implantation procedures that were performed. The respective rate for hardware complications was 3.7%. Surgical complications included postoperative hematoma in 1.9%, infection in 2.6%, vocal cord palsy in 1.4%, lower facial weakness in 0.2%, pain and sensory-related complications in 1.4%, aseptic reaction in 0.2%, cable discomfort in 0.2%, surgical cable break in 0.2%, oversized stimulator pocket in 0.2%, and battery displacement in 0.2% of patients. Hardware-related complications included lead fracture/malfunction in 3.0%, spontaneous VNS turn-on in 0.2%, and lead disconnection in 0.2% of patients. CONCLUSIONS VNS implantation is a relatively safe procedure, but it still involves certain risks. The most common complications are postoperative hematoma, infection, and vocal cord palsy. Although their occurrence rates are rather low at about 2%, these complications may cause major suffering and even be life threatening. To reduce complications, it is important to have a long-term perspective. The 25 years of follow-up of this study is of great strength considering that VNS can be a life-long treatment for many patients. Thus, it is important to include repeated surgeries such as battery and lead replacements, given that complications also may occur with these surgeries.

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“…Stimulation of the nucleus of the solitary tract via vagal nerve stimulation (VNS) has been shown to suppress seizure activity in experimental animals and in humans (for reviews see (Cohen-Gadol et al, 2003;Vonck et al, 2004). It is therefore curious that this region was prominently activated by TZG in the present work and by NMDA in the study of Velisek et al (2007) in infant rats.…”

Section: Discussionmentioning

confidence: 53%

Seizure responses and induction of Fos by the NMDA Agonist (tetrazol-5-yl)glycine in a genetic model of NMDA receptor hypofunction

et al. 2008

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Effects of the direct NMDA agonist (tetrazol-5-yl)glycine (TZG) were examined in a genetic mouse model of reduced NMDA receptor function. In this model, expression of the NR1 subunit is reduced but not eliminated and the mice are therefore designated as NR1 hypomorphic. Previous work suggested that the reduced NR1 subunit expression produced a functional subsensitivity as judged by a blunted Fos induction response to a sub-seizure dose of TZG. In the present study seizure threshold doses of TZG were tested in the wild type and mutant mice. Surprisingly, there was no difference in the seizure sensitivity between the wild type mice and mice presumed to express very low levels of the NR1 subunit. An extensive neuroanatomical analysis of Fos induction was conducted after the threshold seizure doses of TZG. The results demonstrate that some brain regions of the NR1 -/-mice exhibit much lower Fos induction in comparison to the NR1 +/+ mice. These regions include hippocampus, amygdala, and cerebral cortical regions. However, in other regions, similar induction of Fos was observed in both genotypes in response to the NMDA agonist. Regions showing similar Fos induction in the NR1 +/+ and NR1 -/-mice include the lateral septum, nucleus of the solitary tract, and medial hypothalamic regions. The results suggest that the NMDA receptor hypofunction in the NR1 -/-mice is not global but regionally specific and that subcortical structures are responsible for the seizure-inducing effects of TZG.Section 3-Neurophysiology, Neuropharmacology and other forms of Intercellular Communication

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Vagus Nerve Stimulation for Refractory Epilepsy: A Transatlantic Experience

Cited by 112 publications

References 31 publications

Vagal nerve stimulation effects on generalized-partial seizures and medication in adult drug resistans epilepsy patients

Vagal nerve stimulation effects on generalized-partial seizures and medication in adult drug resistans epilepsy patients

Complications and safety of vagus nerve stimulation: 25 years of experience at a single center

Seizure responses and induction of Fos by the NMDA Agonist (tetrazol-5-yl)glycine in a genetic model of NMDA receptor hypofunction

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