title: Vagus nerve stimulation in children less than 5 years old.
abstract: BACKGROUND
  Vagus nerve stimulation (VNS) has been used in both adults and older children with varying success.
  
  
  METHODS
  We retrospectively reviewed our experience with VNS in very young children (below 5 years old). The mean age at stimulator implantation was 20.5 months. Two patients were below 2 years old at implantation and two patients were below 1 year old at their initial surgery. The average follow up time for this group was 22 months.
  
  
  RESULTS
  Of the six patients (three males and three females) with long-term follow up, 83% had a significant decrease in the frequency of their seizure. Of these, two are seizure-free (33%), three are improved (50%), and one (17%) has had no change in seizure status at their most recent clinical examination. Age at implantation of the vagus nerve stimulator did not seem to correlate with patient success. In this group, atonic seizures were found to best respond to VNS with cessation of this type of seizure in two patients. No patients were made worse by the procedure and no morbidity was observed related to VNS.
  
  
  CONCLUSIONS
  Based on our small patient cohort, it appears that VNS in very young children with life-threatening epilepsy can be efficacious. Larger groups and other institutional experiences are now needed to verify our findings.
authors.affiliation: Section of Pediatric Neurosurgery, University of Alabama at Birmingham and Children's Hospital Birmingham, 1600 7th Avenue South ACC 400, Birmingham, AL 35233, USA.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Blount
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Pongkiat
authors.initials: P
authors.lastname: Kankirawatana
authors.forename: Sarah
authors.initials: S
authors.lastname: Kiel
authors.forename: Robert
authors.initials: R
authors.lastname: Knowlton
authors.forename: Paul A
authors.initials: PA
authors.lastname: Grabb
authors.forename: Martina
authors.initials: M
authors.lastname: Bebin
mesh_terms: D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004827:Epilepsy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology*