| Autor: |
Urian FI; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania.; Neurosurgical Department, University Emergency Hospital Bucharest, 050098 Bucharest, Romania., Toader C; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania.; National Institute of Neurovascular Disease, 077160 Bucharest, Romania., Busuioc RC; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania., Glavan LA; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania., Corlatescu AD; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania., Iacob G; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania.; Neurosurgical Department, University Emergency Hospital Bucharest, 050098 Bucharest, Romania., Ciurea AV; Neurosurgical Department, University of Medicine and Pharmacy 'Carol Davila', 020021 Bucharest, Romania.; Sanador Clinical Center Hospital, 010991 Bucharest, Romania.; Medical Science Section, Romanian Academy, 050711 Bucharest, Romania. |
| Abstrakt: |
Background: Evaluating the differential impact of vagus nerve stimulation (VNS) therapy across various seizure types, our study explores its efficacy specifically in patients with categorized minor and major seizures. Methods: We conducted a retrospective cohort study involving 76 patients with pharmacoresistant epilepsy treated at the University Emergency Hospital of Bucharest between 2021 and 2024. Seizures were classified as 'minor' (including focal-aware and non-motor/absence seizures) and 'major' (including focal to bilateral tonic-clonic and generalized motor seizures), based on modified International League Against Epilepsy (ILAE) criteria. This classification allowed us to assess the response to VNS therapy, defined by a 50% or greater reduction in seizure frequency at the 12-month follow-up. Results: Our findings reveal that major seizures respond more favorably to VNS therapy, significantly reducing both frequency and intensity. In contrast, minor seizures showed a less pronounced response in frequency reduction but noted improvements in neurocognitive functions, suggesting a nuanced benefit of VNS in these cases. Conclusion: The study underscores the importance of seizure type in determining the efficacy of VNS therapy, advocating for personalized treatment approaches based on seizure classification. This approach could potentially enhance clinical outcomes by tailoring VNS settings to specific seizure types, improving overall management strategies in pharmacoresistant epilepsy. |
