[Vagal nerve stimulation in children with drug-resistant epilepsy].
BACKGROUND
To evaluate the clinical efficacy and side effects of vagal nerve stimulation (VNS) in Norwegian children with difficult-to-treat epilepsy.


METHODS
We have performed an open retrospective study of 60 children with pharmaco-resistant epilepsy who had a VNS implantation between October 1996 and May 2003. The effects and side effects of VNS were evaluated on the basis of the medical records and a questionnaire filled in by the patients and/or their relatives.


RESULTS
Forty-six patients (77%), 25 females and 21 males, aged 4-16 years at the time of implantation, filled in the questionnaire. All patients had tried > or = 6 antiepileptic drugs prior to the implantation. Five of them had undergone resective epilepsy surgery. After a mean of 2.5 years of follow up, 33 patients (72 %) reported positive effects of VNS. Twenty-nine patients (63%) reported decreased seizure frequency and/or less severe seizures, 20 (43%) achieved > or = 50 % seizure reduction, but only two became seizure free. Sixteen (35%) experienced a shorter and milder postictal phase. In 10 patients (22%) the need of diazepam treatment to terminate seizures was considerably reduced. Twenty-eight of the children (61%) experienced a positive effect of magnet activation. Twenty-three patients (50%) reported minor and waning side effects. Because most of the patients (32) had their antiepileptic medication changed after the implantation, the results should be interpreted with caution.


CONCLUSIONS
A majority of the patients (72%) reported positive effects on seizure frequency and/or epilepsy-related symptoms. The side effects were modest. Our findings support previous reports about VNS being an effective additional treatment in children with refractory epilepsy.
Nevroklinikken-barneavdelingen, Spesialsykehuset for epilepsi, Postboks 53, 1306 Baerum postterminal. anna.bremer@epilepsy.no
Anna
A
Bremer
Ann-Sofie
AS
Eriksson
Geir Ketil
GK
Røste
Bredo
B
Knudtzen
Karl Otto
KO
Nakken
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods; D004828:Epilepsies, Partial / Q000628:therapy; D004827:Epilepsy / Q000628:therapy*; D004829:Epilepsy, Generalized / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013577:Syndrome; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000502:physiology*