| Autor: |
Hamilton, Preci, Soryal, Imad, Dhahri, Prince, Wimalachandra, Welege, Leat, Anna, Hughes, Denise, Toghill, Nicole, Hodson, James, Sawlani, Vijay, Hayton, Tom, Samarasekera, Shanika, Bagary, Manny, McCorry, Dougall, Chelvarajah, Ramesh |
| Zdroj: |
Seizure; May2018, Vol. 58, p120-126, 7p |
| Abstrakt: |
Purpose: To compare the efficacy of AspireSR® to preceding VNS battery models for battery replacements, and to determine the efficacy of the AspireSR® for new implants.Methods: Data were collected retrospectively from patients with epilepsy who had VNS AspireSR® implanted over a three-year period between June 2014 and June 2017 by a single surgeon. Cases were divided into two cohorts, those in whom the VNS was a new insertion, and those in whom the VNS battery was changed from a previous model to AspireSR®. Within each group, the seizure burden was compared between the periods before and after insertion of AspireSR®.Results: Fifty-one patients with a newly inserted AspireSR® VNS model had a significant reduction in seizure frequency (p < 0.001), with 59% (n = 30) reporting ≥50% reduction. Of the 62 patients who had an existing VNS, 53% (n = 33) reported ≥50% reduction in seizure burden when the original VNS was inserted. After the battery was changed to the AspireSR®, 71% (n = 44) reported a further reduction of ≥50% in their seizure burden. The size of this reduction was at least as large as that resulting from the insertion of their existing VNS in 98% (61/62) of patients.Conclusion: The results suggest that approximately 70% of patients with existing VNS insertions could have significant additional benefit from cardiac based seizure detection and closed loop stimulation from the AspireSR® device. For new insertions, the AspireSR® device has efficacy in 59% of patients. The 'rule of thirds' used in counseling patients may need to be modified accordingly. [ABSTRACT FROM AUTHOR] |
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