Vagus nerve stimulation in intractable childhood epilepsy: a Korean multicenter experience.
We evaluated the long-term outcome of vagus nerve stimulation (VNS) in 28 children with refractory epilepsy. Of these 28 children, 15 (53.6%) showed a >50% reduction in seizure frequency and 9 (32.1%) had a >75% reduction. When we compared seizure reduction rates according to seizure types (generalized vs. partial) and etiologies (symptomatic vs. cryptogenic), we found no significant differences. In addition, there was no correlation between the length of the stimulation period and treatment effect. The seizure reduction rate, however, tended to be inversely related to the seizure duration before VNS implantation and age at the time of VNS therapy. VNS also improved quality of life in this group of patients, including improved memory in 9 (32.1%), improved mood in 12 (42.9%), improved behavior in 11 (39.3%), improved alertness in 12 (42.9%), improved achievement in 6 (21.4%), and improved verbal skills in 8 (28.6%). Adverse events included hoarseness in 7 patients, dyspnea at sleep in 2 patients, and wound infection in 1 patient, but all were transient and successfully managed by careful follow-up and adjustment of parameters. These results indicate that VNS is a safe and effective alternative therapy for pediatric refractory epilepsy, without significant adverse events.
You
Su Jeong
SJ
Department of Pediatrics, Epilepsy Center, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea.
Kang
Hoon-Chul
HC
Kim
Heung Dong
HD
Ko
Tae-Sung
TS
Kim
Deok-Soo
DS
Hwang
Yong Soon
YS
Kim
Dong Suk
DS
Lee
Jung-Kyo
JK
Park
Sang Keun
SK
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000379:methods*; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D011788:Quality of Life; D012640:Seizures / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000473:pathology*