title: Vagus nerve stimulation in the treatment of drug-resistant epilepsy in 29 children.
abstract: OBJECTIVE
  Vagus nerve stimulation (VNS) has been demonstrated to be safe and effective for adults and children with drug-resistant epilepsy and is able to improve most types of epilepsy. The aim of this study, in a paediatric population, was to assess the overall efficacy of vagus nerve stimulation on seizures, to assess tolerability and quality of life.
  
  
  METHODS
  This single-centre, retrospective study reviewed the files of 29 children in whom a vagus nerve stimulator was implanted between 1995 and 2012. The response rate (greater than 50% reduction of the seizure frequency), antiepileptic efficacy according to the type of epilepsy or age at implantation or age at onset of epilepsy, the time-course of seizures, adverse effects, overall quality of life and number of hospitalisations were studied.
  
  
  RESULTS
  In our population, vagus nerve stimulation achieved a significant reduction in the seizure frequency throughout follow-up (p = 0.015). Response rates were 59% at 3 months, and 66% at 6 months, and the response rate then remained stable at about 70%. Stimulation tended to be more effective in patients with non-idiopathic partial epilepsy than in patients with non-idiopathic and idiopathic generalised epilepsy (0.01 < p < 0.11). No other predictive factors of efficacy were identified. Patients, parents, caregivers reported improvement in overall quality of life in 38% of patients during clinical interviews. A significant reduction in the number of hospitalisations due to a reduction of seizure frequency was observed after implantation (p = 0.03). VNS was stopped because of complications or insufficient efficacy in 9 cases.
  
  
  CONCLUSIONS
  Vagus nerve stimulation is a safe and effective treatment option in children with drug-resistant epilepsy who are not candidates for surgery.
authors.affiliation: Service de Neurologie Pédiatrique, CHU d'Amiens, Amiens, France. Electronic address: emiliebod@yahoo.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bodin
authors.affiliation: Service de Neurologie Pédiatrique, CHU d'Amiens, Amiens, France.
authors.forename: Anne-Gaëlle
authors.initials: AG
authors.lastname: Le Moing
authors.affiliation: Service d'Explorations Fonctionnelles du Système Nerveux de l'Enfant, CHU d'Amiens, Amiens, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bourel-Ponchel
authors.affiliation: Centre de Référence des Troubles du Langage et des Apprentissages, CHU d'Amiens, Amiens, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Querne
authors.affiliation: Service de Neurochirurgie, CHU d'Amiens, Amiens, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Toussaint
authors.affiliation: Service de Neurologie Pédiatrique, CHU d'Amiens, Amiens, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Berquin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000069279:Drug Resistant Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D055536:Vagus Nerve Stimulation / Q000379:methods*
keywords: Antiepileptic; Children; Drug-resistant epilepsy; Medico-economic; Quality of life; Vagus nerve stimulation