Open Access
CC BY-NC-ND 4.0 · International Journal of Epilepsy 2023; 09(01/02): A1-A40
DOI: 10.1055/s-0044-1791393
Oral Abstracts

OP-9 Outcome of Vagal Nerve Stimulation in Drug Refractory Epilepsy

Authors

  • Anuja Patil

    1   KIMS Hospitals, Telangana, India

  • Sita Jayalakshmi

    1   KIMS Hospitals, Telangana, India

  • Manas Panigrahi

    1   KIMS Hospitals, Telangana, India
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Aim: To evaluate outcome and response of dosing parameters in Vagal nerve stimulation (VNS).

Background: VNS is an FDA-approved treatment in focal epilepsy. Limited literature is available on the dosing parameters and outcome of VNS.

Methods: Retrospective chart review was performed among patients who underwent VNS for drug refractory focal epilepsy from 2010 to 2022. The demographic features, clinical features, seizure frequency pre- and postimplantation was assessed for those with at least 1-year follow-up. Dosing parameters at the latest follow-up were compared.

Results: Out of 21 patients who underwent VNS implantation, 14 (66.6%) were males, average age at implantation was 7 to 29 (17.2) years. About 11 (52.3%) had below normal IQ (<75) before surgery. Behavioral disturbances were present among 16 (76.1%). Average number of ASMs used prior to implantation was 3.8 (3–6). Etiology included, hypoxic ischemic encephalopathy in 13, focal cortical dysplasia in 2, hemispheric atrophy in 1, bilateral hippocampal sclerosis in 1, POLG mutation in 1, and the rest 3 had normal MRI findings. Of these, 3 had failed prior resective surgery for epilepsy while others were naïve. Duration of follow-up ranged from 1 to14 years. Compared at 10 years follow-up, 14 (82%) had at least 50% seizure reduction, while 7 (41.1%) had almost 90% seizure reduction. While at 2 years follow-up, only 9 (64.28%) had 50% or more seizure frequency reduction. One patient with POLG mutation succumbed to status epilepticus. Among dosing parameters, output current ranged from 1 to 2.25 mA, while signal off time ranged from 1.8 to 5 minutes and were comparable among those with or without >50% seizure reduction. About 66.6% patients among better outcome group had undergone implantation within 5 years of seizure onset.

Conclusions: VNS implantation may show substantial seizure reduction especially among those with shorter epilepsy duration and at longer follow-up.



Publication History

Article published online:
12 September 2024

© 2023. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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