Vagus nerve stimulation for symptomatic generalized epilepsy: a pilot study.
OBJECTIVE
Patients with symptomatic generalized epilepsy (SGE) may have antiepileptic drug (AED)-resistant mixed generalized seizures. Vagus nerve stimulation (VNS) reduces partial seizures and may help SGE.


METHODS
We added VNS to stable AED therapy in five SGE patients. Nine-month postoperative VNS treatment seizure rates were compared to a 1-month preoperative baseline.


RESULTS
All patients had mixed generalized seizures, EEG generalized slow spike-and-wave and behavioral abnormalities. Median number of previous AEDs taken was 6 (range 5-12). Median baseline seizure rate was 75/month (range 29-110). VNS produced a median seizure rate production of -41% (range -40% - -85%). Adverse events reported in one patient each were: incisional infection, choking sensation and voice change; and coughing (noted by two patients). One patient discontinued VNS due to coughing.


CONCLUSIONS
We conclude that VNS may be useful add-on therapy for SGE. A larger, controlled, and blinded trial may be warranted.
Labar
D
D
Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, New York 10021, USA.
Nikolov
B
B
Tarver
B
B
Fraser
R
R
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000502:physiology*
D000927:Anticonvulsants