Eur Arch Otorhinolaryngol. 2013 Jan;270(1):355-8. doi: 10.1007/s00405-012-2118-0. Epub 2012 Jul 27.
Vagal nerve stimulation for refractory epilepsy: the surgical procedure and complications in 100 implantations by a single medical center.
Department of Otolaryngology, Head and Neck and Maxillo-facial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann St, 64239, Tel-Aviv, Israel.
In 1997, the US Food and Drug Administration approved the use of intermittent stimulation of the left vagal nerve as adjunctive therapy for seizure control. Vagal nerve stimulation (VNS) has since been considered a safe and effective treatment for medically intractable seizures. The objective of this study is to present our experience with the surgical procedure and outcomes after VNS insertion in the first 100 consecutive patients treated at the Tel-Aviv "Sourasky" Medical Center (TASMC). All patients who underwent VNS device implantation by the authors at TASMC between 2005 and 2011 were studied. The collected data included age at onset of epilepsy, seizure type, duration of epilepsy, age at VNS device implantation, seizure reduction, surgical complications, and adverse effects of VNS over time. Fifty-three males and 47 females, age 21.2 ± 11.1 years, underwent VNS implantation. Indications for surgery were medically refractory epilepsy. The most common seizure type was focal (55 patients, 55 %). Seizure duration until implantation was 14.4 ± 9 years. Mean follow-up time after device insertion was 24.5 ± 22 months. Complications were encountered in 12 patients. The most common complication was local infection (6 patients, 6 %). Six devices were removed-four due to infection and two due to loss of clinical effect. Currently, 63 patients remain in active long-term follow-up; of these, 35 patients have >50 % reduction in frequency of attacks.VNS is a well-tolerated and effective therapeutic alternative in the management of medically refractory epilepsy. The surgical procedure is safe and has a low complication rate.
- [PubMed - indexed for MEDLINE]
Related citations in PubMed
- Refractory epilepsy in tuberous sclerosis: vagus nerve stimulation with or without subsequent resective surgery.[Epilepsy Behav. 2009]
Refractory epilepsy in tuberous sclerosis: vagus nerve stimulation with or without subsequent resective surgery.
Elliott RE, Carlson C, Kalhorn SP, Moshel YA, Weiner HL, Devinsky O, Doyle WK. Epilepsy Behav. 2009 Nov; 16(3):454-60. Epub 2009 Sep 19.
- Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases.[J Neurosurg Pediatr. 2011]
Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases.
Elliott RE, Rodgers SD, Bassani L, Morsi A, Geller EB, Carlson C, Devinsky O, Doyle WK. J Neurosurg Pediatr. 2011 May; 7(5):491-500.
- Short-term results of vagus nerve stimulation in pediatric patients with refractory epilepsy.[Pediatr Neonatol. 2012]
Short-term results of vagus nerve stimulation in pediatric patients with refractory epilepsy.
Chen CY, Lee HT, Chen CC, Kwan SY, Chen SJ, Hsieh LP, Tsai JD, Taiwan Child Neurology Society VNS Study Group. Pediatr Neonatol. 2012 Jun; 53(3):184-7. Epub 2012 Jun 5.
- Review Vagal nerve stimulation for refractory epilepsy in children: indications and experience at The Hospital for Sick Children.[Childs Nerv Syst. 2006]
Review Vagal nerve stimulation for refractory epilepsy in children: indications and experience at The Hospital for Sick Children.
Benifla M, Rutka JT, Logan W, Donner EJ. Childs Nerv Syst. 2006 Aug; 22(8):1018-26. Epub 2006 Jul 1.
- Review Clinical course of young patients with Dravet syndrome after vagal nerve stimulation.[Eur J Paediatr Neurol. 2011]
Review Clinical course of young patients with Dravet syndrome after vagal nerve stimulation.
Zamponi N, Passamonti C, Cappanera S, Petrelli C. Eur J Paediatr Neurol. 2011 Jan; 15(1):8-14. Epub 2010 Oct 23.