Vagus nerve stimulation in the treatment of drug-resistant epilepsy in 29 children. (May 2016)

• Record Type: Journal Article
• Authors: Bodin, Emilie; Le Moing, Anne-Gaëlle; Bourel-Ponchel, Emilie; Querne, Laurent; Toussaint, Patrick; Berquin, Patrick
• Is Part Of: European journal of paediatric neurology. Volume 20:Number 3(2016:May)
• Page Start: 346
• Page End: 351
• Publication Date: 2016-05
• Subjects: Vagus nerve stimulation -- Drug-resistant epilepsy -- Children -- Antiepileptic -- Quality of life -- Medico-economic; Pediatric neurology -- Periodicals; Nervous System Diseases -- Periodicals; Child -- Periodicals; Infant -- Periodicals; Neurologie pédiatrique -- Périodiques; Pediatric neurology; Electronic journals; Periodicals; Electronic journals; 618.928
• DOI: 10.1016/j.ejpn.2016.01.011
• Languages: English
• ISSNs: 1090-3798

Abstract

Abstract: Background/purpose: Vagus nerve stimulation (VNS) has been demonstrated to be safe and effective for adults and children with drug-resistant epilepsy and is able to improve most types of epilepsy. The aim of this study, in a paediatric population, was to assess the overall efficacy of vagus nerve stimulation on seizures, to assess tolerability and quality of life. Methods: This single-centre, retrospective study reviewed the files of 29 children in whom a vagus nerve stimulator was implanted between 1995 and 2012. The response rate (greater than 50% reduction of the seizure frequency), antiepileptic efficacy according to the type of epilepsy or age at implantation or age at onset of epilepsy, the time-course of seizures, adverse effects, overall quality of life and number of hospitalisations were studied. Results: In our population, vagus nerve stimulation achieved a significant reduction in the seizure frequency throughout follow-up (p = 0.015). Response rates were 59% at 3 months, and 66% at 6 months, and the response rate then remained stable at about 70%. Stimulation tended to be more effective in patients with non-idiopathic partial epilepsy than in patients with non-idiopathic and idiopathic generalised epilepsy (0.01 < p < 0.11). No other predictive factors of efficacy were identified. Patients, parents, caregivers reported improvement in overall quality of life in 38% of patients during clinical interviews. A significant reduction in the number of hospitalisations due to a reduction of seizure frequency was observed after implantation (p = 0.03). VNS was stopped because of complications or insufficient efficacy in 9 cases. Conclusion: Vagus nerve stimulation is a safe and effective treatment option in children with drug-resistant epilepsy who are not candidates for surgery. Highlights: Long term effect on epilepsy. Significant reduction in the seizures frequency over time. Overall improvement in the quality of life with decrease of hospitalisations. More efficiency on non idiopathic partial epilepsies. Good tolerability.