Vagus nerve stimulation in pediatric epileptic syndromes.
Vagal nerve stimulation (VNS) has shown promising results in various cohorts of non-surgical refractory epilepsy in adults and children. However studies report a significant delay between implantation and clinical response. We describe a cohort of 28 children and adolescents prospectively followed, classified by epileptic syndromes and treated with VNS using a 6-week rapid ramping protocol between January 2000 and March 2005. Our cohort showed favorable outcome within 6 months which was sustained at 24 months: 68% (19/28) showing >or=50% reduction in seizure frequency, including 14% (4/28) who became seizure-free. VNS was particularly efficacious in children with cryptogenic generalized and partial epilepsies. Although adverse events occurred in 68% (19/28) of patients, most were transient. In conclusion, rapid ramping is associated with an early and lasting response in most children but with a slightly higher side-effect rate.
Rossignol
E
E
Hôpital Sainte-Justine, Département de neurologie pédiatrique, Canada.
Lortie
A
A
Thomas
T
T
Bouthiller
A
A
Scavarda
D
D
Mercier
C
C
Carmant
L
L
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004827:Epilepsy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010372:Pediatrics; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D014630:Vagus Nerve / Q000502:physiology*
D000927:Anticonvulsants