title: Treatment of Refractory Status Epilepticus with Vagus Nerve Stimulator in an Elderly Patient.
abstract: BACKGROUND
  One of the risks of a traumatically induced intracranial bleed is development of new onset seizures. Rarely would these seizures progress to status epilepticus (SE) or refractory SE. There is a lack of literature on the use of a vagus nerve stimulator in these situations in older adults.
  
  
  METHODS
  We present a 67-year-old patient who developed refractory status epilepticus within days after evacuation of a right-sided spontaneous subdural hematoma. He was refractory to multiple antiepileptic agents and phenobarbiturate- and propofol-induced coma. He then underwent a left vagus nerve stimulator (VNS) implantation. Within a few days of implantation, he improved dramatically. Within 2 weeks of VNS implantation, he was neurologically intact and was transferred to an inpatient rehabilitation facility. Within a short time thereafter, he was fully functional and able to take care of all of his activities.
  
  
  CONCLUSIONS
  A vagus nerve stimulator should be considered in cases of refractory status epilepticus, regardless of age. Excellent outcome can be achieved even if a short course of medication-induced coma is unsuccessful.
authors.affiliation: Division of Neurosurgery, St. Elizabeth's Hospital, Belleville, Illinois, USA. Electronic address: joeyaz21@yahoo.com.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Yazdi
authors.affiliation: Division of Neurosurgery, St. Elizabeth's Hospital, Belleville, Illinois, USA.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Schumaker
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D000069279:Drug Resistant Epilepsy / Q000628:therapy*; D004569:Electroencephalography; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D013226:Status Epilepticus / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D055536:Vagus Nerve Stimulation / Q000379:methods*
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic medication; Elderly; Status epilepticus; Subdural hematoma; Vagus nerve stimulator