Vagus nerve stimulation in 16 children with refractory epilepsy.
OBJECTIVE
Vagus nerve stimulation (VNS) has been reported to produce >90% reduction in the number of seizures in children with intractable epilepsy. These encouraging results need confirmation.


METHODS
Sixteen children, 10 boys and 6 girls aged 4-19 years, were treated with VNS (Cyberonics, Webster, TX, U.S.A.) for 12-24 months. Seizure frequency, seizure severity, changes in quality of life (QOL: visual analogue scale), and side effects were recorded. Eight children had partial and 8 had generalized seizures; 4 of the latter had Lennox-Gastaut syndrome (LGS).


RESULTS
During the tenth to twelfth month of VNS, 6 of 16 children experienced > or =50% reduction in seizure frequency. One girl became seizure-free. Seizure severity showed an average decrease in the score from 15 to 11. After 10 months of treatment, QOL was estimated to have improved > or =50% in 6 of 16 children. Reduction in seizure frequency, decreased seizure severity, and reported improvement in QOL did not entirely coincide. Six children experienced hoarseness, 1 had neck pain, 2 had hypersalivation, 2 experienced tiredness, 2 had aspiration episodes during liquid intake, and 6 had electrical transmission problems; in 4 the problem has been surgically corrected. Five stimulators were turned off due to lack of efficacy.


CONCLUSIONS
Six of 16 children with refractory epilepsy treated with VNS improved, with a reduction not only in seizure frequency but also in seizure severity and in QOL.
Department of Pediatrics, University Hospital, Lund, Sweden.
J
J
Lundgren
P
P
Amark
G
G
Blennow
L G
LG
Strömblad
L
L
Wallstedt
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation; D004827:Epilepsy / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000502:physiology*
D000927:Anticonvulsants