title: [Vagus nerve stimulation for intractable epilepsy: A retrospective bicentric cohort study of 101 patients operated on between 1999 and 2010].
abstract: BACKGROUND
  Vagus nerve stimulation is an adjunctive palliative therapy for refractory epilepsy.
  
  
  METHODS
  We reviewed the clinical and surgical records of patients who had a VNS implantation for intractable epilepsy between the years 1999 and 2010 at two institutions, Bordeaux and Toulouse University Hospitals.
  
  
  RESULTS
  A total of 101 patients were included of whom 57 were male. Median age at epilepsy onset was 7.5 years, inter quartile range (IQR) [2.5-12.5] and the median time between epilepsy onset and VNS implantation was 21.1 years, IQR [11.9-29.5]. At the end of the study, 85 patients were alive with a functional VNS. Survival probability of having a functional VNS at 1, 2 and 5 years were respectively: 99%, IC95% [97.1,100]; 96.49%, IC95% [92.7,100] and, 88.2%, IC95% [79.9,97.4]. Among the patients, 41.6% demonstrated a seizure decrease of more than 50%. The mean number of seizures was reduced by 5.7 per week. We failed to demonstrate any factor affecting the outcome.
  
  
  CONCLUSIONS
  The VNS can decrease the seizure frequency but, also reduce their intensity and had a favourable effect on the patients mood. Morbidity is low and the therapeutic effect of the stimulation is sustainable. The indication of the VNS should be discussed earlier in the evolution of a nonsurgical and severe epilepsy.
authors.affiliation: Service de neurochirurgie, hôpital Pellegrin, 33076 Bordeaux, France; Service de neurochirurgie, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France. Electronic address: Charles.Champeaux@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Champeaux
authors.affiliation: Service de neurologie, unité d'épileptologie, hôpital Pellegrin, 33076 Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Marchal
authors.affiliation: Service de neurologie, pôle neurosciences, hôpital Pierre-Paul-Riquet, 31059 Toulouse, France.
authors.forename: L
authors.initials: L
authors.lastname: Valton
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Facteurs prédictifs; Intractable epilepsy; Outcome; Predictors; Pronostic; Seizures; Stimulation du nerf vague; Vagus nerve stimulation; Épilepsie pharmacorésistante