In:
Epilepsia, Wiley, Vol. 55, No. 10 ( 2014-10), p. 1576-1584
Abstract:
To gain insight into the longâterm impact of vagus nerve stimulation (with VNS Therapy) in children with drugâresistant epilepsy, we conducted the largest retrospective multicenter study to date over an extended followâup period of up to 24Â months. Methods The primary objective was to assess change in seizure frequency of the predominant seizure type (defined as the most disabling seizure) following VNS device implantation. Treating physicians collected data from patient records from baseline to 6, 12, and 24Â months of followâup. Results The analysis population included 347Â children (aged 6Â months to 17.9Â years at the time of implant). At 6, 12, and 24Â months after implantation, 32.5%, 37.6%, and 43.8%, respectively, of patients had â„50%Â reduction in baseline seizure frequency of the predominant seizure type. The responder rate was higher in a subgroup of patients who had no change in antiepileptic drugs (AEDs) during the study. Favorable results were also evident for all secondary outcome measures including changes in seizure duration, ictal severity, postictal severity, quality of life, clinical global impression of improvement, and safety. Post hoc analyses demonstrated a statistically significant correlation between VNS total charge delivered per day and an increase in response rate. VNS Therapy is indicated as adjunctive therapy in children with focal, structural epilepsies, who for any reason are not good candidates for surgical treatment following the trial of two or more AEDs. Children with predominantly generalized seizures from genetic, structural epilepsies, like Dravet syndrome or LennoxâGastaut syndrome, could also benefit from VNS Therapy. Significance The results demonstrate that adjunctive VNS Therapy in children with drugâresistant epilepsy reduces seizure frequency and is well tolerated over a 2âyear followâup period. No new safety issues were identified. A post hoc analysis revealed a doseâresponse correlation for VNS in patients with epilepsy.
Type of Medium:
Online Resource
ISSN:
0013-9580
,
1528-1167
DOI:
10.1111/epi.2014.55.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2002194-X
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