Vagus nerve stimulation: effectiveness and tolerability in 64 paediatric patients with refractory epilepsies

Epileptic Disord. 2011 Dec;13(4):382-8. doi: 10.1684/epd.2011.0479.


Aim: We discuss the effectiveness, tolerability, and safety of vagus nerve stimulation (VNS) as adjunctive therapy in 64 paediatric patients with refractory epilepsies.

Materials and methods: Sixty-four patients (34 male and 30 female) implanted with VNS for refractory epilepsy were analysed. Electroclinical features were compatible with Lennox-Gastaut syndrome in 46 patients, focal epilepsies in 10 patients, Dravet syndrome in three patients, epilepsy with myoclonic-astatic seizures in three patients, and West syndrome in two. The NeuroCybernetic Prosthesis (NCP) system (Cyberonics, Webster, TX, USA) was employed and the following stimulation parameters were used: output current of 1 to 2.5mA, signal frequency of 30Hz, signal pulse width of 500μs, and signal "on" and "off" times of 30 seconds and 5 minutes, respectively.

Results: Of 46 patients with LGS, 30 cases showed a significant improvement in seizure control, with a reduction in seizure frequency of at least 50%. Ten patients with focal epilepsy, three patients with myoclonic-astatic seizures, two patients with Dravet, and two patients with West 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 a significant number of patients, reduced seizure severity and shorter recovery time and hospital stay were also observed. VNS was well tolerated in all patients.

Conclusion: VNS is an effective and well-tolerated treatment for paediatric patients with refractory epilepsies, improving quality of life and neuropsychological performance.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Drug Resistance
  • Electric Stimulation Therapy / adverse effects
  • Electric Stimulation Therapy / methods*
  • Electrodes, Implanted
  • Epilepsies, Myoclonic / therapy
  • Epilepsies, Partial / therapy
  • Epilepsy / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Intellectual Disability / therapy
  • Lennox Gastaut Syndrome
  • Male
  • Neuropsychological Tests
  • Retrospective Studies
  • Spasms, Infantile / therapy
  • Treatment Outcome
  • Vagus Nerve Stimulation / adverse effects
  • Vagus Nerve Stimulation / methods*
  • Young Adult

Supplementary concepts

  • Epileptic encephalopathy, Lennox-Gastaut type