Although vagus nerve stimulation (VNS) is an effective alternative option for patients with refractory epilepsy unsuitable for conventional resective surgery, predictors of a better control of seizure frequency and severity are still unavailable. This prospective study reports on 39 patients, including 4 children affected by epilepsia partialis continua (EPC), who underwent VNS for refractory epilepsy. The overall seizure frequency outcome was classified into three groups according to reduction rate: ≥75%, ≥50%, and <50%. Engel and McHugh classifications were also used. The median follow-up period was 36months. A seizure reduction rate ≥50% or EPC improvement was observed in 74% of the patients. Twenty-one out of 35 cases (60%) resulted in Engel classes II and III. Outcome, as defined by the McHugh scale, showed a responder rate of 71%. These results suggest that younger patient age and focal or multifocal epilepsy are related to a better seizure control and cognitive outcome. Vagus nerve stimulation could also be considered as an effective procedure in severe conditions, such as drug-refractory EPC.

Vagus nerve stimulation in refractory epilepsy : New indications and outcome assessment / C.E. Marras, V. Chiesa, A. De Benedictis, A. Franzini, M. Rizzi, F. Villani, F. Ragona, L. Tassi, A. Vignoli, E. Freri, N. Specchio, G. Broggi, M. Casazza, M.P. Canevini. - In: EPILEPSY & BEHAVIOR. - ISSN 1525-5050. - 28:3(2013 Jul 05), pp. 374-378.

Vagus nerve stimulation in refractory epilepsy : New indications and outcome assessment

V. Chiesa;M. Rizzi;A. Vignoli;M.P. Canevini
2013

Abstract

Although vagus nerve stimulation (VNS) is an effective alternative option for patients with refractory epilepsy unsuitable for conventional resective surgery, predictors of a better control of seizure frequency and severity are still unavailable. This prospective study reports on 39 patients, including 4 children affected by epilepsia partialis continua (EPC), who underwent VNS for refractory epilepsy. The overall seizure frequency outcome was classified into three groups according to reduction rate: ≥75%, ≥50%, and <50%. Engel and McHugh classifications were also used. The median follow-up period was 36months. A seizure reduction rate ≥50% or EPC improvement was observed in 74% of the patients. Twenty-one out of 35 cases (60%) resulted in Engel classes II and III. Outcome, as defined by the McHugh scale, showed a responder rate of 71%. These results suggest that younger patient age and focal or multifocal epilepsy are related to a better seizure control and cognitive outcome. Vagus nerve stimulation could also be considered as an effective procedure in severe conditions, such as drug-refractory EPC.
Palliative surgery ; Refractory epilepsy ; Vagus nerve stimulation
Settore MED/39 - Neuropsichiatria Infantile
5-lug-2013
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/223768
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