title: Outcomes of vagal nerve stimulation in a pediatric population: a single center experience.
abstract: OBJECTIVE
  To evaluate the efficacy of vagus nerve stimulation (VNS) in pediatric patients with medically refractory epilepsy.
  
  
  METHODS
  We reviewed the medical records of 252 consecutive patients who underwent VNS implantation at a single center over a 5-year period. Patients with complete 6- and 12-month follow-up data were included. Analysis was also done across various subgroups including gender, age at implantation, seizure type, abnormal MRI findings pre-implantation, number of medications at baseline, history of SE, and duration of epilepsy.
  
  
  RESULTS
  Complete follow-up data were available for 69 patients. Median seizure reduction for these patients was 50% (Q1: 0%; Q3: 73%) at 6 months and 40% (Q1: -25%; Q3: 75%) at 12 months. When stratified by baseline seizure frequency, there was a significant reduction from baseline of 61% at 6 months and 69% at 12 months for patients in the high-baseline frequency group. There were no significant reductions at month 6 or 12 months for the lower-baseline frequency group. Adverse events were reported in 40.6% (28 out of 69 patients). Six patients had the VNS removed for reasons including lack of efficacy and side effects and were excluded from the study group.
  
  
  CONCLUSIONS
  VNS provides significant seizure reduction, in particular in pediatric patients with a higher baseline seizure frequency.
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Physiology, McGill University, Montreal, Quebec, Canada.
authors.forename: Camilla
authors.initials: C
authors.lastname: Yu
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Pediatrics, The Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
authors.forename: Sriram
authors.initials: S
authors.lastname: Ramgopal
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Mark
authors.initials: M
authors.lastname: Libenson
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Imane
authors.initials: I
authors.lastname: Abdelmoumen
authors.affiliation: Clinical Research Program, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Powell
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States; Department of Psychology, Emory University, Atlanta, GA, United States.
authors.forename: Kyle
authors.initials: K
authors.lastname: Remy
authors.affiliation: Department of Neurosurgery, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Madsen
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rotenberg
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States. Electronic address: tobias.loddenkemper@childrens.harvard.edu.
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000009:adverse effects; D055815:Young Adult
keywords: Brain stimulation; Cranial Nerve; Efficacy; Epilepsy; Medically refractory epilepsy; Outcome; Pediatric; Seizure; Seizure control; Stimulation; Vagus nerve stimulation