Quality of life after vagal nerve stimulator insertion.
OBJECTIVE
Assess quality-of-life after vagal nerve stimulation and determine patient characteristics associated with improvement in quality-of-life.


METHODS
Sixteen patients (11 children, 5 adults) who had vagal nerve stimulation at our center were studied. Quality-of-life was assessed pre- and post-vagal nerve stimulation using the Quality-of-Life in Childhood Epilepsy questionnaire for children and the Epilepsy Surgery Inventory-55 for adults.


RESULTS
Sixteen patients who did not qualify for resective surgery were included; seven (43.75%) were males and 9 (56.25%) were females. Mean age at onset of seizures was 3.96 +/- 4.00 years and at surgery was 15.78 +/- 10.78. Follow-up time was 1.26 +/- 0.92 years. Fourteen patients (87.5%) were mentally retarded. Ten (62.5%) had cryptogenic etiology and 6 patients (37.5%) symptomatic etiology. Fifty percent had localization-related epilepsy. Six of 7 patients with generalized cryptogenic etiology (85.71%) had Lennox-Gastaut syndrome. Seizures dropped from 122.31 +/- 159.49 to 67.84 +/- 88.22 seizures/month. Seizure reduction (> 50%) correlated with improvement in total quality-of-life (p = 0.034). Post-vagal nerve stimulation, the total group scored significantly higher in the social domain (p = 0.039). In patients with localization-related epilepsy, significant improvements were detected in the social domain (p = 0.049) and in total quality-of-life (p = 0.042).


CONCLUSIONS
Despite a diverse and small population size, we observed significant improvements in the social domain 1.26 years post-vagal nerve stimulation. In addition, there was an improvement in total quality-of-life amongst patients with partial seizures. Finally, seizure reduction was associated with quality-of-life improvement. Our results support previous studies from the West reporting improvement in quality-of-life following vagal nerve stimulation, contradict those studies that did not show such differences, and are the first coming from a developing country.
Mikati
Mohamad A
MA
Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon. mohamad.mikati@duke.edu
Ataya
Nour F
NF
El-Ferezli
Jessica C
JC
Baghdadi
Tarafa S
TS
Turkmani
Ali H
AH
Comair
Youssef G
YG
Kansagra
Sujay
S
Najjar
Marwan W
MW
D000293:Adolescent; D000328:Adult; D002648:Child; D003071:Cognition; D004644:Emotions; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012919:Social Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000009:adverse effects / Q000379:methods; D055815:Young Adult