J Korean Med Sci.  2007 Jun;22(3):442-445. 10.3346/jkms.2007.22.3.442.

Vagus Nerve Stimulation in Intractable Childhood Epilepsy: a Korean Multicenter Experience

• You SJ
• Kang HC
• Kim HD
• Ko TS
• Kim DS
• Hwang YS
• Kim DS
• Lee JK
• Park SK

• KMID: 1778351
• DOI: http://doi.org/10.3346/jkms.2007.22.3.442

Abstract

We evaluated the long-term outcome of vagus nerve stimulation (VNS) in 28 children with refractory epilepsy. Of these 28 children, 15 (53.6%) showed a >50% reduction in seizure frequency and 9 (32.1%) had a >75% reduction. When we compared seizure reduction rates according to seizure types (generalized vs. partial) and etiologies (symptomatic vs. cryptogenic), we found no significant differences. In addition, there was no correlation between the length of the stimulation period and treatment effect. The seizure reduction rate, however, tended to be inversely related to the seizure duration before VNS implantation and age at the time of VNS therapy. VNS also improved quality of life in this group of patients, including improved memory in 9 (32.1%), improved mood in 12 (42.9%), improved behavior in 11 (39.3%), improved altertness in 12 (42.9%), improved achievement in 6 (21.4%), and improved verbal skills in 8 (28.6%). Adverse events included hoarseness in 7 patients, dyspnea at sleep in 2 patients, and wound infection in 1 patient, but all were transient and successfully managed by careful follow-up and adjustment of parameters. These results indicate that VNS is a safe and effective alternative therapy for pediatric refractory epilepsy, without significant adverse events.

Keyword

Vagus Nerve Stimulation; Epilepsy; Child

MeSH Terms

Adolescent
Child
Child, Preschool
Electric Stimulation Therapy/*methods
Epilepsy/*therapy
Female
Humans
Korea
Male
Quality of Life
Seizures/therapy
Time Factors
Treatment Outcome
Vagus Nerve/*pathology

Figure

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  Fig. 1 Recommended protocol of VNS parameter settings.

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  Fig. 2 Changes in seizure reduction after 3, 6, and 12 months and at last follow-up.

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  Fig. 3 Quality of life improvements.

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