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Efficacy of vagal nerve stimulation in children with medically refractory epilepsy.
Neurosurgery. 2000 Dec; 47(6):1353-7; discussion 1357-8.N

Abstract

OBJECTIVE

The effects of vagal nerve stimulation (VNS) on seizure frequency and quality of life were analyzed retrospectively in children with medically refractory epilepsy.

METHODS

Thirty-eight children aged 11 months to 16 years underwent implantation of vagal nerve stimulators. Age of seizure onset, duration of epilepsy, and seizure type and frequency were recorded preoperatively. Age at implantation, length of follow-up, seizure type and frequency, and change in quality of life (QOL) were recorded postoperatively. Changes in QOL were assigned a QOL score by the caretakers on a visual analog scale of -1 (much worse) to +1 (much improved).

RESULTS

The median follow-up period was 12 months (range, 10-18 mo). Eleven (29%), 15 (39%), 5 (13%), and 7 (18%) children had greater than 90% reduction, 50 to 90% reduction, less than 50% reduction, and no reduction in seizure frequency, respectively. For all children, seizure reduction by seizure type was as follows: atonic (80%), absence (65%), complex partial (48%), and generalized tonicoclonic (45%). The mean change in QOL score was 0.61. Eighty-six percent of the children had QOL scores of 0.5 (improved) or higher. Follow-up of at least 6 months was associated with greater seizure reduction (P = 0.05) and higher QOL score (P < 0.01). Seizure reduction was greater in children with onset of epilepsy after 1 year of age (P < 0.05). The age of the child and duration of epilepsy were not associated with greater or lesser degrees of seizure reduction.

CONCLUSION

VNS provided improvements in seizure control for the majority of children regardless of age. QOL was improved in the majority of children with VNS. VNS should be considered for children with medically refractory epilepsy who have no surgically resectable focus.

Authors+Show Affiliations

Division of Neurosurgery, University of Alabama at Birmingham, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11126906

Citation

Patwardhan, R V., et al. "Efficacy of Vagal Nerve Stimulation in Children With Medically Refractory Epilepsy." Neurosurgery, vol. 47, no. 6, 2000, pp. 1353-7; discussion 1357-8.
Patwardhan RV, Stong B, Bebin EM, et al. Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. Neurosurgery. 2000;47(6):1353-7; discussion 1357-8.
Patwardhan, R. V., Stong, B., Bebin, E. M., Mathisen, J., & Grabb, P. A. (2000). Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. Neurosurgery, 47(6), 1353-7; discussion 1357-8.
Patwardhan RV, et al. Efficacy of Vagal Nerve Stimulation in Children With Medically Refractory Epilepsy. Neurosurgery. 2000;47(6):1353-7; discussion 1357-8. PubMed PMID: 11126906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. AU - Patwardhan,R V, AU - Stong,B, AU - Bebin,E M, AU - Mathisen,J, AU - Grabb,P A, PY - 2000/12/29/pubmed PY - 2001/3/3/medline PY - 2000/12/29/entrez SP - 1353-7; discussion 1357-8 JF - Neurosurgery JO - Neurosurgery VL - 47 IS - 6 N2 - OBJECTIVE: The effects of vagal nerve stimulation (VNS) on seizure frequency and quality of life were analyzed retrospectively in children with medically refractory epilepsy. METHODS: Thirty-eight children aged 11 months to 16 years underwent implantation of vagal nerve stimulators. Age of seizure onset, duration of epilepsy, and seizure type and frequency were recorded preoperatively. Age at implantation, length of follow-up, seizure type and frequency, and change in quality of life (QOL) were recorded postoperatively. Changes in QOL were assigned a QOL score by the caretakers on a visual analog scale of -1 (much worse) to +1 (much improved). RESULTS: The median follow-up period was 12 months (range, 10-18 mo). Eleven (29%), 15 (39%), 5 (13%), and 7 (18%) children had greater than 90% reduction, 50 to 90% reduction, less than 50% reduction, and no reduction in seizure frequency, respectively. For all children, seizure reduction by seizure type was as follows: atonic (80%), absence (65%), complex partial (48%), and generalized tonicoclonic (45%). The mean change in QOL score was 0.61. Eighty-six percent of the children had QOL scores of 0.5 (improved) or higher. Follow-up of at least 6 months was associated with greater seizure reduction (P = 0.05) and higher QOL score (P < 0.01). Seizure reduction was greater in children with onset of epilepsy after 1 year of age (P < 0.05). The age of the child and duration of epilepsy were not associated with greater or lesser degrees of seizure reduction. CONCLUSION: VNS provided improvements in seizure control for the majority of children regardless of age. QOL was improved in the majority of children with VNS. VNS should be considered for children with medically refractory epilepsy who have no surgically resectable focus. SN - 0148-396X UR - https://www.unboundmedicine.com/medline/citation/11126906/Efficacy_of_vagal_nerve_stimulation_in_children_with_medically_refractory_epilepsy_ DB - PRIME DP - Unbound Medicine ER -