Vagus nerve stimulation for treatment of medically intractable seizures. Evaluation of long-term outcome.
Vagus nerve stimulation (VNS) constitutes an adjunctive, modern management of medically intractable seizures, especially when surgery is inadvisable.


OBJECTIVE
To evaluate the long-term results as regards efficacy, safety and tolerability of VNS in epileptic subjects, with focal and/or generalised seizures, refractory to old and new AEDs, without indication for resective surgery.


METHODS
51 epileptic subjects (30 males, 21 females), aged 7-49 years, have been implanted so far.


RESULTS
The results refer to the 47 subjects with a follow-up longer than 6 months. 22 (46.8%) of them had a greater than 50% reduction in seizure frequency, with a more than 75% reduction in 6. No significant difference was found in relation to type of seizures. The efficacy maintained steadily over time during the follow-up (mean 26.4 months). Twelve out of the 47 subjects had an improvement in alertness, attention and psychomotor activity. Complications were observed in 5 cases, leading to removal of the stimulator in 2. A moderate vocal hoarseness (40.4%), paresthesia (6.3%), pharingodinia and cough (4.3%) were the registered adverse events.


CONCLUSIONS
Our results confirm that VNS is effective, safe and well tolerated and constitutes an alternative treatment for pharmacoresistant epileptic seizures.
Tanganelli
Paolo
P
Department of Neurology--Epilepsy Centre, P.A. Micone Hospital, Genoa, Italy.
Ferrero
Sergio
S
Colotto
Patrizio
P
Regesta
Giovanni
G
D000293:Adolescent; D000328:Adult; D002648:Child; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000628:therapy*; D013995:Time; D014630:Vagus Nerve / Q000502:physiology*