Vagus nerve stimulation: effectiveness and tolerability in patients with epileptic encephalopathies

Childs Nerv Syst. 2011 May;27(5):787-92. doi: 10.1007/s00381-010-1314-8. Epub 2010 Oct 31.

Abstract

Purpose: We discuss the effectiveness, tolerability, and safety of vagus nerve stimulation (VNS) as adjunctive therapy in 26 patients with refractory epileptic encephalopathies (EEs).

Material and methods: Twenty-six patients (17 male and 9 female) with electroclinical features compatible with Lennox-Gastaut syndrome (LGS) in 20 patients, Dravet syndrome (DS) in 3 patients, and epilepsy with myoclonic-astatic seizures (EMAS) in 3 patients implanted with the NCP system were analyzed.

Results: In our series of patients with LGS, 17 cases showed a significant improvement in seizure control, with a reduction in seizure frequency of at least 50%. Seven of them previously had epileptic spasms. Three patients with EMAS and two patients with DS showed a significant improvement in seizure control, with a reduction in seizure frequency of at least 50%. A good clinical response was evident early and efficacy progressively improved with the duration of treatment up to 36 months. In patients who had a reduction in seizure frequency of at least 50%, quality of life (QOL) and neuropsychological performance improved. VNS was well-tolerated in all patients.

Conclusion: VNS is an effective and well-tolerated treatment for patients with epileptic encephalopathies EEs, improving QOL and neuropsychological performance.

MeSH terms

  • Adolescent
  • Brain Diseases / complications
  • Brain Diseases / therapy
  • Child
  • Child, Preschool
  • Electrodes, Implanted / adverse effects
  • Epilepsy / complications
  • Epilepsy / therapy*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Quality of Life
  • Vagus Nerve Stimulation* / adverse effects
  • Young Adult