title: Vagal Nerve Stimulation for Drug-Resistant Epilepsy: Adverse Events and Outcome in a Series of Patients with Long-Term Follow-Up.
abstract: Vagal nerve stimulation (VNS) is a palliative treatment option for drug-resistant epilepsy. The aim of this study was to describe the clinical and demographic features of selected patients scheduled for VNS and to evaluate the long-term efficacy of VNS in seizure control.
  
  
  
  Between 2006 and 2013, 32 consecutive epileptic patients (14 male and 18 female) were enrolled at our Institute for VNS implantation. In all cases resective surgery had previously been excluded by the use of a noninvasive presurgical study protocol. Mean age was 32 years (range 18-50), and mean epilepsy duration 23 years (range 11-39). All subjects were followed-up for at least 2 years (mean 6 years, range 2-9) after VNS implantation. Patients were considered responders when a reduction of seizures of more than 50 % was reported.
  
  
  
  All patients had complex partial seizures, in 81 % of the patients with secondary generalization and in 56 % with drop attacks. Neurological examination revealed focal deficits in 19 % of the patients. Brain magnetic resonance imaging (MRI) was positive in 47 % of the patients. No surgical complications were observed in this series. Three patients were lost to follow-up. Twelve patients were classified as responders. Among the others, 1 patient experienced side effects (snoring and groaning during sleep) and the device was removed.
  
  
  
  Our data confirm that VNS is a safe procedure and a valid palliative treatment option for drug-resistant epileptic patients not suitable for resective surgery.
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy. roberta.morace@yahoo.it.
authors.forename: R
authors.initials: R
authors.lastname: Morace
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Di Gennaro
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: P P
authors.initials: PP
authors.lastname: Quarato
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Aniello
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mascia
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Grammaldo
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: M
authors.initials: M
authors.lastname: De Risi
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sparano
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Di Cola
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.|Department of Neuroscience and Reproductive and Odontostomatological Science, University of Naples "Federico II", Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: De Angelis
authors.affiliation: I.R.C.C.S. Neuromed, Pozzilli, Italy.|Department of Neurology and Psychiatry, University of Rome "Sapienza", Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Esposito
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D000069279:Drug Resistant Epilepsy / Q000503:physiopathology / Q000628:therapy*; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; 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
keywords: Drug-resistant epilepsy; Intractable epilepsy; Neuromodulation; Palliative surgery; Vagal nerve stimulation