Effect of vagus nerve stimulation in the treatment of pediatric intractable epilepsy: a preliminary analysis

FANG Tie; FANG Fang; ZHANG Jie; TAI Jun; XU Jinshan; WANG Shengcai; DING Changhong; DENG Jie; XIE Zihang; NI Xin

Abstract：Objective Implant vagus nerve stimulation is considered as an adjunctive treatment for intractable epilepsy where patients are not suitable for resective surgery.This research is designed to identify the safety and efficacy of vagus nerve stimulation in children intractable epilepsy,and analyze the effects on different epilepsy syndromes.Methods Eligible children with intractable epilepsy were recruited in the research,and we collected data from pre-operative assessments as the baseline.During the follow-up time,we recorded the process of seizures (frequency,duration,and seizure type),the changes of drugs or parameters,the complications and so on.In the research we had chosen the mean reduction rate of seizures,response rate,and McHugh scale as the indictors.Results A total of 32 patients were implanted with vagus nerve stimulators,and the average age was 6.6 years.In the follow-up time of post-operative 1 month,3 months,6 months,9 months and 12 months,the average reduction rate was 8.79％,50.85％,40.67％,56.54％,and 66.62％,while the response rate was 21.87％,62.50％,57.14％,69.23％ and 77.78％.In addition,IVNS had different effects on epilepsy syndromes,the reduction rate of WEST syndmme was increased from 37.64％ (post-operative 1 m) to 83.33％ (post-operative 12 m),and the Lennox-Gastuat syndrome'reduction rate was improved from 27.42％ to 55.10％ in 6 months.Conclusion Vagus nerve stimulation is safe and effective in children intractable epilepsy,and the seizure reduction occurs in a time-dependent manner.Moreover,WEST syndrome and LG syndrome may get the most benefits from IVNS.