title: Vagus nerve stimulation for refractory epilepsy: a transatlantic experience.
abstract: Vagus nerve stimulation (VNS) is an alternative treatment for medically or surgically refractory epilepsy. The long-term efficacy and safety of VNS were evaluated in a large patient series at Ghent University Hospital and Dartmouth-Hitchcock Medical Center. Between March 1995 and February 2003, seizure frequency and type as well as prescribed antiepileptic drugs and side effects were prospectively assessed in 131 patients treated with VNS in either center. Patients with a minimum follow-up duration of 6 months were included in the efficacy and safety analysis. A total of 118 of 131 implanted patients had a minimum postimplantation follow-up period of 6 months (mean, 33 months). The mean age of these patients was 32 years and the mean duration of refractory epilepsy was 22 years. The mean reduction in monthly seizure frequency in all patients was 55% (range, 0-100; SD = 31.6). Seven percent of patients were free of seizures with impaired consciousness, 50% of patients had a seizure frequency reduction of more than 50%, and 21% of patients were nonresponders. Fifteen patients reported stimulation-related side effects such as hoarseness or gagging. In a large patient series from two geographically distinct epilepsy centers located in two different continents, VNS proved to be efficacious and safe during long-term follow-up.
authors.affiliation: Department of Neurology, Reference Center for Refractory Epilepsy, Ghent University Hospital, Gent, Belgium. kristl.vonck@UGent.be
authors.forename: Kristl
authors.initials: K
authors.lastname: Vonck
authors.forename: Vijay
authors.initials: V
authors.lastname: Thadani
authors.forename: Karen
authors.initials: K
authors.lastname: Gilbert
authors.forename: Stefanie
authors.initials: S
authors.lastname: Dedeurwaerdere
authors.forename: Liesbeth
authors.initials: L
authors.lastname: De Groote
authors.forename: Veerle
authors.initials: V
authors.lastname: De Herdt
authors.forename: Lut
authors.initials: L
authors.lastname: Goossens
authors.forename: Fleur
authors.initials: F
authors.lastname: Gossiaux
authors.forename: Erik
authors.initials: E
authors.lastname: Achten
authors.forename: Evert
authors.initials: E
authors.lastname: Thiery
authors.forename: Guy
authors.initials: G
authors.lastname: Vingerhoets
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Roost
authors.forename: Jacques
authors.initials: J
authors.lastname: Caemaert
authors.forename: Jacques
authors.initials: J
authors.lastname: De Reuck
authors.forename: David
authors.initials: D
authors.lastname: Roberts
authors.forename: Peter
authors.initials: P
authors.lastname: Williamson
authors.forename: Paul
authors.initials: P
authors.lastname: Boon
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004827:Epilepsy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014630:Vagus Nerve