The role of vagus nerve stimulation in the treatment of refractory epilepsy: Clinical outcomes and impact on quality of life

Neurologia (Engl Ed). 2019 Jul 22;S0213-4853(19)30080-5. doi: 10.1016/j.nrl.2019.04.002. Online ahead of print.
[Article in English, Spanish]

Abstract

Background: Vagus nerve stimulation (VNS) is used as a complementary therapy to pharmacological treatment in patients with refractory epilepsy. This study aims to evaluate the efficacy of VNS in reducing seizure frequency, severity, and duration; reducing the number of antiepileptic drugs administered; and improving patients' quality of life.

Material and methods: We analysed the clinical progression of 70 patients with refractory epilepsy treated with VNS at Hospital Universitario de Alicante and Hospital Clínico de Valencia. Data were collected before and after the procedure. The difference in seizure frequency pre- and post-VNS was classified using the McHugh scale. Data were also collected on seizure duration and severity, the number of drugs administered, and quality of life.

Results: According to the McHugh classification, 12.86% of the patients were Class I, 44.29% were Class II, 40% were Class III, and the remaining 2.86% of patients were Class IV-V. A≥50% reduction in seizure frequency was observed in 57.15% of patients. Improvements were observed in seizure duration in 88% of patients and in seizure severity in 68%; the number of drugs administered was reduced in 66% of patients, and 93% reported better quality of life.

Conclusions: VNS is effective for reducing seizure frequency, duration, and severity and the number of antiepileptic drugs administered. It also enables an improvement in patients' quality of life.

Keywords: Antiepileptic drugs; Calidad de vida; Crisis epilépticas; Crisis generalizadas; Epilepsia refractaria; Estimulación del nervio vago; Fármacos antiepilépticos; Generalised seizures; Quality of life; Refractory epilepsy; Seizures; Vagus nerve stimulation.