title: The Israeli retrospective multicenter open-label study evaluating vagus nerve stimulation efficacy in children and adults.
abstract: BACKGROUND
  The management of intractable epilepsy in children and adults is challenging. For patients who do not respond to anti-epileptic drugs and are not suitable candidates for epilepsy surgery, vagal nerve stimulation (VNS) is a viable alternative for reducing seizure frequency.
  
  
  METHODS
  In this retrospective multicenter open-label study we examined the efficacy and tolerability of VNS in patients in five adult and pediatric epilepsy centers in Israel. All patients had drug-resistant epilepsy and after VNS implantation in 2006-2007 were followed for a minimum of 18 months. Patients were divided into two age groups: < 21 and > 21 years old.
  
  
  RESULTS
  Fifty-six adults and children had a stimulator implanted in 2006-2007. At 18 months post-VNS implantation, none of the patients was seizure-free, 24.3% reported a reduction in seizures of > or = 75%, 19% reported a 50-75% reduction, and 10.8% a 25-50% reduction. The best response rate occurred in patients with complex partial seizures. Among these patients, 7 reported a > or = 75% reduction, 5 patients a 50-75% reduction, 3 patients a 25-50% reduction, and 8 patients a < 25% reduction. A comparison of the two age groups showed that the older group (< 21 years old) had fewer seizures than the younger group.
  
  
  CONCLUSIONS
  VNS is a relatively effective and safe palliative method for treating refractory epilepsy in both adults and children. It is an alternative treatment for patients with drug-resistant epilepsy, even after a relatively long disease duration, who are not candidates for localized epilepsy surgery.
authors: Pediatric Neurology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. bguac@yahoo.com
authors: Shay
authors: S
authors: Menascu
authors: Pediatric Neurology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors: Uri
authors: U
authors: Kremer
authors: Adult Neurology Unit, Rambam Medical Center, Haifa, Israel.
authors: Yitzhak
authors: Y
authors: Schiller
authors: Adult Epilepsy Unit, Sheba Medical Center, Tel Hashomer, Israel.
authors: Ilan
authors: I
authors: Blatt
authors: Pediatric Neurology Unit, Meir Medical Center, Kfar Saba, Israel.
authors: Nathan
authors: N
authors: Watemberg
authors: Adult Epilepsy Unit, Sheba Medical Center, Tel Hashomer, Israel.
authors: Marina
authors: M
authors: Boxer
authors: Pediatric Neurology Unit, Schneider Children's Medical Center, Petah Tikva, Israel.
authors: Hadasa
authors: H
authors: Goldberg
authors: Department of Adult Neurology, Shaare Zedek Medical Center, Jerusalem, Israel.
authors: Isabella
authors: I
authors: Korn-Lubetzki
authors: Pediatric Neurology Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
authors: Moshe
authors: M
authors: Steinberg
authors: Pediatric Neurology Unit, Safra Children's Hospital, Tel Hashomer, Israel.
authors: Bruria
authors: B
authors: Ben-Zeev
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D004351:Drug Resistance; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants