J Neurosurg Pediatr. 2012 Jul 6. [Epub ahead of print]
Vagus nerve stimulation for partial and generalized epilepsy from infancy to adolescence.
Source
Departments of Neurological Surgery and.Abstract
Object Vagus nerve stimulation (VNS) is approved by the FDA for the treatment of partial epilepsy in patients older than 12 years. Authors of the current study performed a large retrospective analysis and comparison of VNS outcomes in children with an age ≥ and < 12 years, including those with partial and generalized epilepsy. Methods A retrospective review of the records of pediatric patients (age < 18 years) who had undergone primary VNS system implantation between 2001 and 2010 by a single pediatric neurosurgeon was undertaken. Considered data included demographics, epilepsy type (partial vs generalized), seizure frequency, seizure duration, postictal period duration, and antiepileptic medication use. Results One hundred forty-six patients (49% female) were followed up for a mean of 41 months after VNS implantation. Thirty-two percent of patients had partial epilepsy and 68% had generalized epilepsy. After VNS system implantation, seizure frequency was reduced in 91% of patients, seizure duration in 50%, postictal period in 49%, and antiepileptic medication use in 75%. There was no significant difference in age, sex, or duration of follow-up according to epilepsy type. Neither was there any significant difference in seizure frequency reduction, seizure duration, postictal period, medication use, overall clinical improvement, or improvement in quality of life based on an age ≥ or < 12 years or epilepsy type. Conclusions Vagus nerve stimulation reduced both seizure frequency and antiepileptic medication use in the majority of pediatric patients regardless of sex, age cohort, or epilepsy type. Vagus nerve stimulation also reduced seizure duration and postictal period in approximately half of the pediatric patients. Contrary to expectation, children with partial epilepsy do not benefit from VNS at higher rates than those with generalized epilepsy.http://www.ncbi.nlm.nih.gov/pubmed/22768964
Related citations in PubMed
- Earlier use of adjunctive vagus nerve stimulation therapy for refractory epilepsy.[Neurology. 2002]
- Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases.[J Neurosurg Pediatr. 2011]
- Refractory epilepsy in tuberous sclerosis: vagus nerve stimulation with or without subsequent resective surgery.[Epilepsy Behav. 2009]
- Review Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response.[J Neurosurg. 2011]
- Review Vagus nerve stimulation use and effect in epilepsy: what have we learned?[Epilepsy Behav. 2006]
No comments:
Post a Comment