Vagus nerve stimulation: longitudinal follow-up of patients treated for 5 years.
We performed a retrospective, multicenter, open-label study to evaluate the efficacy of vagus nerve stimulation (VNS) in all patients in the Czech Republic who have received this treatment for at least 5 years (n=90). The mean last follow-up was 6.6+/-1.1 years (79+/-13 months). The median number of seizures among all patients decreased from 41.2 seizures/month in the prestimulation period to 14.9 seizures/month at 5 years follow-up visit. The mean percentage of seizure reduction was 55.9%. The responder rate in these patients is in concordance with the decrease of overall seizure frequency. At 1 year after beginning the stimulation, 44.4% of patients were responders; this percentage increased to 58.7% after 2 years. At the 5 years last follow-up 64.4% of patients were responders, 15.5% experienced > or = 90% seizure reduction, and 5.5% were seizure-free. A separate analysis of patients younger than 16 years of age showed lower efficacy rates of VNS in comparison to the whole group. Complications and chronic adverse effects occurred in 13.3% of patients. VNS is an effective and safe method to refractory epilepsy in common clinical practice.
Kuba
Robert
R
Brno Epilepsy Center; First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Pekarská 53, Czech Republic. robert.kuba@fnusa.cz
Brázdil
Milan
M
Kalina
Miroslav
M
Procházka
Tomás
T
Hovorka
Jirí
J
Nezádal
Tomás
T
Hadac
Jan
J
Brozová
Klára
K
Sebronová
Vera
V
Komárek
Vladimír
V
Marusic
Petr
P
Oslejsková
Hana
H
Zárubová
Jana
J
Rektor
Ivan
I
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018153:Czech Republic / Q000453:epidemiology; D004827:Epilepsy / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D010147:Pain Measurement; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods*