Observations on the use of vagus nerve stimulation earlier in the course of pharmacoresistant epilepsy: patients with seizures for six years or less

Neurologist. 2003 May;9(3):160-4. doi: 10.1097/00127893-200305000-00004.


Background: This study retrospectively compared the effectiveness of vagus nerve stimulation (VNS) therapy among a constant cohort of patients in the patient outcome registry, which systematically monitors outcomes of patients receiving VNS therapy. Patients in the study had pharmacoresistant seizures for 6 years or less (early treatment group) or more than 6 years (late treatment group) before initiation of VNS therapy, and results are provided after both 3 and 12 months.

Review summary: Of 405 patients, 51 were in the early and 354 in the late treatment groups. Median age at onset of seizures was 7 years in the early and 4.5 years in the late treatment group. Seizure reduction of 100% was reported in 7.8% (early) and 3.7% (late) patients at 3 months and 11.8% (early) and 4.5% (late) at 12 months (P = 0.033). Reductions in seizure frequency greater than or equal to 90% for early and late treatment groups were similar: 11.8% (early) and 11.0% (late) at 3 months and 23.5% (early) and 17.0% (late) at 12 months.

Conclusions: Patients treated earlier with VNS therapy were twice as likely to report no seizures as patients who had seizures for more than 6 years before they received VNS therapy. The effectiveness of VNS therapy should be assessed among other patients with pharmacoresistant seizures and lesser cumulative seizure loads.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anticonvulsants / therapeutic use
  • Child
  • Child, Preschool
  • Cohort Studies
  • Electric Stimulation Therapy / statistics & numerical data*
  • Epilepsy / physiopathology*
  • Epilepsy / therapy*
  • Follow-Up Studies
  • Humans
  • Infant
  • Middle Aged
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Registries / statistics & numerical data*
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Vagus Nerve / physiopathology*


  • Anticonvulsants