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Long-term vagus nerve stimulation in children with focal epilepsy

Authors

  • M. Ryzí,

    Corresponding author
    • Department of Child Neurology, Epilepsy Center Brno, Faculty of Medicine, Brno University Hospital, Masaryk University, Brno, Czech Republic
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  • M. Brázdil,

    1. First Department of Neurology, Epilepsy Center Brno, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
    2. Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
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  • Z. Novák,

    1. Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
    2. Department of Neurosurgery, Epilepsy Center Brno, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
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  • J. Chrastina,

    1. Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
    2. Department of Neurosurgery, Epilepsy Center Brno, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
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  • H. Ošlejšková,

    1. Department of Child Neurology, Epilepsy Center Brno, Faculty of Medicine, Brno University Hospital, Masaryk University, Brno, Czech Republic
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  • I. Rektor,

    1. First Department of Neurology, Epilepsy Center Brno, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
    2. Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
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  • R. Kuba

    1. Department of Child Neurology, Epilepsy Center Brno, Faculty of Medicine, Brno University Hospital, Masaryk University, Brno, Czech Republic
    2. First Department of Neurology, Epilepsy Center Brno, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
    3. Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
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Michal Ryzí, Department of Child Neurology, Epilepsy Center Brno, Faculty of Medicine, Brno University Hospital, Masaryk University, Brno, Černopolní 9, Czech Republic

Tel.: 00420 532 234 937

Fax: 00420 532 234 996

e-mail: mryzi@seznam.cz

Abstract

Objectives

The aim of the study was to evaluate the long-term efficacy and hospitalization rates in children with refractory focal epilepsy treated by vagus nerve stimulation.

Materials and methods

We retrospectively analyzed 15 children with intractable focal epilepsy treated by vagus nerve stimulation (mean age of 14.6 ± 2.5 years at the time of implantation). We analyzed the treatment effectiveness at 1, 2, and 5 year follow-up visits. We counted the average number of urgent hospitalizations and number of days of urgent hospitalization per year for each patient before and after the VNS implantation.

Results

The mean seizure reduction was 42.5% at 1 year, 54.9% at 2 years, and 58.3% at 5 years. The number of responders was 7 (46.7%) at 1 year and 9 (60%) at both 2 and 5 years. The mean number of urgent hospitalizations per patient was 1.0 ± 0.6 per year preoperatively and 0.3 ± 0.5 per year post-operatively (P < 0.0001). The mean number of days of urgent hospitalization per patient was 9.3 ± 6.1 per year preoperatively and 1.3 ± 1.8 per year post-operatively (P < 0.0001).

Conclusions

Vagus nerve stimulation is an effective method of treating children with refractory focal epilepsy. It leads to a substantial decrease in the number and duration of urgent hospitalizations.

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