Vagus nerve stimulation for partial and generalized epilepsy from infancy to adolescence: Clinical article

Eric M. Thompson, Susan E. Wozniak, Colin M. Roberts, Amy Kao, Valerie C. Anderson, Nathan R. Selden

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Abstract

Object. Vagus nerve stimulation (VNS) is approved by the FDA for the treatment of partial epilepsy in patients older than 12 years. Authors of the current study performed a large retrospective analysis and comparison of VNS outcomes in children with an age ≥ and <12 years, including those with partial and generalized epilepsy. Methods. A retrospective review of the records of pediatric patients (age <18 years) who had undergone primary VNS system implantation between 2001 and 2010 by a single pediatric neurosurgeon was undertaken. Considered data included demographics, epilepsy type (partial vs generalized), seizure frequency, seizure duration, postictal period duration, and antiepileptic medication use. Results. One hundred forty-six patients (49% female) were followed up for a mean of 41 months after VNS implantation. Thirty-two percent of patients had partial epilepsy and 68% had generalized epilepsy. After VNS system implantation, seizure frequency was reduced in 91% of patients, seizure duration in 50%, postictal period in 49%, and antiepileptic medication use in 75%. There was no significant difference in age, sex, or duration of follow-up according to epilepsy type. Neither was there any significant difference in seizure frequency reduction, seizure duration, postictal period, medication use, overall clinical improvement, or improvement in quality of life based on an age e or <12 years or epilepsy type. Conclusions. Vagus nerve stimulation reduced both seizure frequency and antiepileptic medication use in the majority of pediatric patients regardless of sex, age cohort, or epilepsy type. Vagus nerve stimulation also reduced seizure duration and postictal period in approximately half of the pediatric patients. Contrary to expectation, children with partial epilepsy do not benefit from VNS at higher rates than those with generalized epilepsy.

LanguageEnglish (US)
Pages200-205
Number of pages6
JournalJournal of Neurosurgery: Pediatrics
Volume10
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Vagus Nerve Stimulation
Generalized Epilepsy
Partial Epilepsy
Seizures
Anticonvulsants
Pediatrics
Epilepsy
Quality of Life
Demography

Keywords

  • Generalized epilepsy
  • Partial epilepsy
  • Pediatrics
  • Vagus nerve stimulation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Vagus nerve stimulation for partial and generalized epilepsy from infancy to adolescence : Clinical article. / Thompson, Eric M.; Wozniak, Susan E.; Roberts, Colin M.; Kao, Amy; Anderson, Valerie C.; Selden, Nathan R.

In: Journal of Neurosurgery: Pediatrics, Vol. 10, No. 3, 09.2012, p. 200-205.

Research output: Contribution to journalArticle

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abstract = "Object. Vagus nerve stimulation (VNS) is approved by the FDA for the treatment of partial epilepsy in patients older than 12 years. Authors of the current study performed a large retrospective analysis and comparison of VNS outcomes in children with an age ≥ and <12 years, including those with partial and generalized epilepsy. Methods. A retrospective review of the records of pediatric patients (age <18 years) who had undergone primary VNS system implantation between 2001 and 2010 by a single pediatric neurosurgeon was undertaken. Considered data included demographics, epilepsy type (partial vs generalized), seizure frequency, seizure duration, postictal period duration, and antiepileptic medication use. Results. One hundred forty-six patients (49{\%} female) were followed up for a mean of 41 months after VNS implantation. Thirty-two percent of patients had partial epilepsy and 68{\%} had generalized epilepsy. After VNS system implantation, seizure frequency was reduced in 91{\%} of patients, seizure duration in 50{\%}, postictal period in 49{\%}, and antiepileptic medication use in 75{\%}. There was no significant difference in age, sex, or duration of follow-up according to epilepsy type. Neither was there any significant difference in seizure frequency reduction, seizure duration, postictal period, medication use, overall clinical improvement, or improvement in quality of life based on an age e or <12 years or epilepsy type. Conclusions. Vagus nerve stimulation reduced both seizure frequency and antiepileptic medication use in the majority of pediatric patients regardless of sex, age cohort, or epilepsy type. Vagus nerve stimulation also reduced seizure duration and postictal period in approximately half of the pediatric patients. Contrary to expectation, children with partial epilepsy do not benefit from VNS at higher rates than those with generalized epilepsy.",
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