[Vagus nerve stimulation in drug-resistant epilepsy. Experience with 23 patients].
BACKGROUND
Vagal nerve stimulation (VNS) is a new non-pharmacological method of pharmacoresistant epilepsy treatment. The aim of this paper was to present effects of treatment in 23 patients with drug-resistant epilepsy with a different etiology.


METHODS
Implantation and treatment was performed in two centers in 1998-2002. The effect of treatment was presented as a reduction of seizures during therapy.


RESULTS
The lack of group homogeneity and a small number of patients (especially a small number of patients with a long follow-up period) did not allow a more detailed analysis to be made, although there seems to be a clear tendency to obtain better effects of treatment over follow-up time (at 24 month more than 50% seizure reduction or cease of seizures was observed in 80% of patients). The possibility to turn on the device "on demand" is an important advantage of this method. This raises the effectiveness of treatment in more than 80% of patients, and in more than 20% it stops the seizure. There were two groups of undesired side effects: frequent specific effects caused by local irritation of the vagal nerve in the cervical part of the neck and rare transient general effects. Both groups of effects rarely caused any treatment complications.


CONCLUSIONS
VNS is an effective method of treatment, complementary to other epilepsy treatment methods and should be used in patients with drug-resistant epilepsy as an alternative to neurosurgical treatment. VNS improves the quality of life in treated patients.
Zwoliński
Piotr
P
Klinika Neurochirurgii, Instytut-Pomnik Centrum Zdrowia Dziecka, Aleja Dzieci Polskich 20, 04-730 Warszawa. piotr.zwolinski@neuronet.pl
Roszkowski
Marcin
M
Drabik
Krzysztof
K
Baczuk
Lech
L
Majkowski
Jerzy
J
D000293:Adolescent; D000328:Adult; D002648:Child; D019091:Critical Pathways; D004351:Drug Resistance; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology