title: The neuropsychological outcome of pediatric patients with refractory epilepsy treated with VNS--A 24-month follow-up in Taiwan.
abstract: OBJECTIVE
  Multiple studies have reported the benefits of vagus nerve stimulation (VNS) on neuropsychological outcomes. The aim of this study was to investigate how VNS affects cognition and psychosocial adjustment in children with refractory epilepsy (RE), and to determine the efficacy of VNS in a Taiwanese population.
  
  
  METHODS
  We conducted a one-group pretest-posttest study on pediatric patients with RE. The study comprised 19 males and 18 females, all aged <18 years. We recorded seizure frequency at 3, 12, and 24 months after VNS device implantation. Intelligence quotients (IQ) were assessed using the Wechsler Intelligence Scale for Children - IV. The Parental Stress Index (PSI) scores were evaluated by a pediatric psychologist.
  
  
  RESULTS
  Vagus nerve stimulation device implantation significantly reduced seizure frequency at 3, 12 and 24 months, especially in young children (<12 years). No significant improvement in IQ test performance was observed, though there were significant improvements in the PSI, especially in young children.
  
  
  CONCLUSIONS
  Vagus nerve stimulation device implantation does not significantly improve cognition function, but it does significantly reduce seizure frequency and stress in parent-child relationships, especially in young children (<12 years). These findings suggest that VNS should be considered as an alternative therapy for patients proven to have seizures that are medically refractory, especially those younger than 12 years of age.
authors: School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors: Jeng-Dau
authors: JD
authors: Tsai
authors: Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors: Ying-Chao
authors: YC
authors: Chang
authors: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors: Lung-Chang
authors: LC
authors: Lin
authors: Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan. Electronic address: klhung@cgh.org.tw.
authors: Kun-Long
authors: KL
authors: Hung
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000069279:Drug Resistant Epilepsy / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D010287:Parent-Child Relations; D011446:Prospective Studies; D002666:Psychology, Child / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods / Q000639:trends*; D014888:Wechsler Scales
keywords: Parental Stress Index; Pediatric patients; Refractory epilepsy; Seizures reduction; Vagus nerve stimulation