Long term effect of vagus nerve stimulation in pediatric intractable epilepsy: an extended follow-up
| Autor: | Ebru Arhan, Gökhan Kurt, Tugba Hirfanoglu, Erhan Bilir, Ayse Serdaroglu, Kürşad Aydın, Atilla Erdem |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Drug Resistant Epilepsy Adolescent Vagus Nerve Stimulation medicine.medical_treatment Anorexia 03 medical and health sciences Epilepsy 0302 clinical medicine Sore throat Medicine Humans 030212 general & internal medicine Longitudinal Studies Adverse effect Child Retrospective Studies business.industry Retrospective cohort study General Medicine medicine.disease Magnetic Resonance Imaging Treatment Outcome Anesthesia Child Preschool Pediatrics Perinatology and Child Health Female Neurology (clinical) Neurosurgery medicine.symptom business 030217 neurology & neurosurgery Vagus nerve stimulation |
| Zdroj: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 32(4) |
| ISSN: | 1433-0350 |
| Popis: | Over the past two decades, vagus nerve stimulation (VNS) has become an accepted and viable treatment modality for intractable epilepsy both in children and adults. Earlier studies have demonstrated short-term seizure outcomes, usually for up to 5 years; so far, none have reported an extended outcome in children. We aimed to assess long term seizure outcome in children with intractable epilepsy for more than 5 years. We identified patients who had VNS implantation for treatment of intractable epilepsy from March 2000 to March 2015 at our Epilepsy Center and collected data including demographic, age at epilepsy onset and VNS implantation, duration of epilepsy, seizure type, number of antiepilepsy drugs (AEDs), and monthly seizure frequency before VNS implantation and at the last clinic visit. Phone surveys were conducted with patients without recent clinic follow-up. Fifty-six patients (aged 4–17 at the time of implant) are the subjects of the study. Seizure reduction of >50 % was achieved in 9.8 % (6th month), 24 % (2nd year), 46.4 % (3rd year), and 54 %(5th year), and overall 35 (62.5 %) of the 56 subjects had a greater than 50 % reduction in seizure frequency at the last follow-up. Eleven patients became seizure free. The results, once obtained, were maintained steadily or even improved over time without any loss of efficacy during the follow-up. The only parameter, significantly related with clinical response, was age at seizure onset. The most frequent adverse events were hoarseness, cough, sore throat, and anorexia, experienced by 13 patients. Two patients had local wound infections and lead to the removal of the stimulator. An improvement in alertness, attention, and psychomotor activity, independent of the efficacy of vagal nerve stimulation, was observed in 8 patients. To our knowledge, this is the first pediatric study evaluating seizure outcome over more than 5 years of follow-up, and demonstrates a favorable seizure outcome of >50 % seizure frequency in 62.5 % of patients and seizure freedom in 11 patients. It is well tolerated over an extended period of time. |
| Databáze: | OpenAIRE |
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