Vagus Nerve Stimulation for Intractable Epilepsy

2011 ◽  
pp. 807-812
Author(s):  
James E. Baumgartner ◽  
Gretchen K. Von Allmen
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy

Implanted vagus nerve stimulation in 126 patients: surgical technique and complications

2020 ◽  
Vol 99 (7) ◽  
Keyword(s):  
Vagus Nerve ◽  
Vocal Cord ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Pulse Generator ◽  
Operative Procedure ◽  
Intractable Epilepsy ◽  
Vagal Nerve ◽  
University Hospital ◽  
Nerve Stimulator

Introduction: Vagus nerve stimulation is a palliative treatment for patients with refractory epilepsy to reduce the frequency and intensity of seizures. A bipolar helical electrode is placed around the left vagus nerve at the cervical level and is connected to the pulse generator placed in a subcutaneous pocket, most commonly in the subclavian region. Methods: Between March 1998 and October 2019, we performed 196 procedures related to the vagal nerve stimulation at the Neurosurgery Department in Motol University Hospital. Of these, 126 patients were vagal nerve stimulator implantation surgeries for intractable epilepsy. The cases included 69 female and 57 male patients with mean age at the time of the implantation surgery 22±12.4 years (range 2.1−58.4 years). Results: Nine patients (7.1%) were afflicted by complications related to implantation. Surgical complications included postoperative infection in 1.6%, VNS-associated arrhythmias in 1.6%, jugular vein bleeding in 0.8% and vocal cord paresis in 2.4%. One patient with vocal cord palsy also suffered from severe dysphagia. One patient (0.8%) did not tolerate extra stimulation with magnet due to a prolonged spasm in his throat. The extra added benefit of vagus stimulation in one patient was a significant reduction of previously regular severe headaches. Conclusion: Vagus nerve stimulation is an appropriate treatment for patients with drug-resistant epilepsy who are not candidates for focal resective surgery. Implantation of the vagus nerve stimulator is a relatively safe operative procedure.

Long term effect of vagus nerve stimulation in pediatric intractable epilepsy: an extended follow-up

2016 ◽  
Vol 32 (4) ◽  
pp. 641-646 ◽  
Author(s):  
Ayse Serdaroglu ◽  
Ebru Arhan ◽  
Gökhan Kurt ◽  
Atilla Erdem ◽  
Tugba Hirfanoglu ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy ◽  
Term Effect ◽  
Long Term Effect

scholarly journals P.018 Forced normalization after vagal nerve stimulation in a case of intractable Lennox-Gastaut syndrome

2018 ◽  
Vol 45 (s2) ◽  
pp. S20-S20
Author(s):  
A Denton ◽  
A Vitali ◽  
K Waterhouse ◽  
J Tellez-Zenteno
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Psychiatric Symptoms ◽  
Intractable Epilepsy ◽  
Complex Case ◽  
Drop Attacks ◽  
Intractable Seizures ◽  
Forced Normalization ◽  
Clonic Seizures

Background: Forced normalization is the development of psychiatric symptoms in a patient experiencing remission of intractable seizures. The mechanism of this phenomenon is unknown. We present a complex case of Lennox Gastaut syndrome that experiences forced normalization after vagus nerve stimulation (VNS). Methods: This case details a 31-year-old male with seizures since early childhood. The patient has intractable epilepsy and failed AEDs, VNS, and a partial callosotomy. Results: The patient was in remission from 2-12 years old, when seizures returned at a frequency of 2-5 per day. He has multiple types of seizures including drop attacks, absences, and tonic-clonic seizures. Patient experienced status epilepticus multiple times. Twelve AEDs were failed before VNS was started in 2010, which helped curb the severity of seizures and the potential for clusters. Forced normalization developed over the course of treatment with VNS. The patient behavior was characterized by aggression, paranoia, and hallucinations. VNS was turned off late in 2010 and then re-started in January of 2011. Patient proceeded to cycle between several days of seizures without psychiatric symptoms and several days of psychosis without seizures. Conclusions: Vagus nerve stimulation gave way to forced normalization, characterized here as aggressive behaviour and psychosis. Forced normalization is seen commonly after epilepsy surgery, but rarely following VNS.

Vagus Nerve Stimulation for Intractable Epilepsy: Outcomes in Children and Adults

2009 ◽  
Vol 13 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Won Chul Namgung ◽  
Tae Sung Ko ◽  
Sang-Ahm Lee ◽  
Joong Ku Kang ◽  
Seok Ho Hong ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy

Vagus Nerve Stimulation in Intractable Epilepsy Associated With SCN1A Gene Abnormalities

2017 ◽  
Vol 32 (5) ◽  
pp. 494-498 ◽  
Author(s):  
Stephen P. Fulton ◽  
Kate Van Poppel ◽  
Amy L. McGregor ◽  
Basanagoud Mudigoudar ◽  
James W. Wheless
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Seizure Control ◽  
Intractable Epilepsy ◽  
Myoclonic Epilepsy ◽  
Dravet Syndrome ◽  
Severe Myoclonic Epilepsy ◽  
Scn1a Gene ◽  
Myoclonic Epilepsy Of Infancy

Mutations in the SCN1A gene cause a spectrum of epilepsy syndromes. There are 2 syndromes that are on the severe end of this spectrum. The classic severe form, Dravet syndrome, is an epileptic encephalopathy of childhood, causing cognitive decline as well as intractable seizures. Severe Myoclonic Epilepsy of Infancy–Borderline (SMEIB) is a term used to include cases with similar severities as those with Dravet syndrome, but lacking a single feature of classic severe myoclonic epilepsy of infancy. Vagus nerve stimulation is a nonpharmacologic treatment for intractable epilepsy. A retrospective review was conducted of patients with deleterious SCN1A mutations who had vagus nerve stimulation placement for treatment of their intractable epilepsy. These children had onset of their epilepsy between 3 and 29 months of age. Seizure control was assessed 6 months after implantation. Twenty patients are included in the study, with 12 implanted at our institution. Nine of the 12 patients implanted at our institution, who had confirmed pre- and post-implantation seizure assessments, showed improvement in seizure control, which was defined as >50% reduction in generalized tonic-clonic seizures, and 4 of those 12 reported improvement in cognitive or speech development. Seven of the 8 patients not implanted at our institution reported subjective benefit, with 4 relating “marked improvement” or seizure freedom. Vagus nerve stimulation appears to impart a benefit to children with deleterious SCN1A gene abnormalities associated with intractable epilepsy.

P6-1 Effect of vagus nerve stimulation on EEG and seizure frequency in children with intractable epilepsy

2010 ◽  
Vol 121 ◽  
pp. S134
Author(s):  
B. Unay ◽  
E. Erdogan ◽  
S. Vurucu ◽  
Z. Gokcil ◽  
N. Bulakbasi ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy

VAGUS NERVE STIMULATION THERAPY AFTER FAILED CRANIAL SURGERY FOR INTRACTABLE EPILEPSY

Neurosurgery ◽  
2008 ◽  
Vol 62 (suppl_2) ◽  
pp. 1086-1093 ◽  
Author(s):  
Arun Paul Amar ◽  
Michael L.J. Apuzzo ◽  
Charles Y. Liu
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy ◽  
Cranial Surgery

The effects of vagus nerve stimulation on tryptophan metabolites in children with intractable epilepsy

2014 ◽  
Vol 37 ◽  
pp. 133-138 ◽  
Author(s):  
S. Klinkenberg ◽  
C.J.H. van den Borne ◽  
M.W. Aalbers ◽  
P. Verschuure ◽  
A.G. Kessels ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy ◽  
Tryptophan Metabolites

Vagus nerve stimulation in children with intractable epilepsy: indications, complications and outcome

2009 ◽  
Vol 25 (9) ◽  
pp. 1097-1100 ◽  
Author(s):  
S. M. R. Kabir ◽  
C. Rajaraman ◽  
C. Rittey ◽  
H. S. Zaki ◽  
A. A. Kemeny ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy

scholarly journals Rates and Predictors of Seizure Freedom With Vagus Nerve Stimulation for Intractable Epilepsy

Neurosurgery ◽  
2015 ◽  
Vol 79 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Dario J. Englot ◽  
John D. Rolston ◽  
Clinton W. Wright ◽  
Kevin H. Hassnain ◽  
Edward F. Chang
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Intractable Epilepsy ◽  
Progressive Increase ◽  
Seizure Type ◽  
Seizure Freedom ◽  
Outcome Registry ◽  
Over Time

AbstractBACKGROUND:Neuromodulation-based treatments have become increasingly important in epilepsy treatment. Most patients with epilepsy treated with neuromodulation do not achieve complete seizure freedom, and, therefore, previous studies of vagus nerve stimulation (VNS) therapy have focused instead on reduction of seizure frequency as a measure of treatment response.OBJECTIVE:To elucidate rates and predictors of seizure freedom with VNS.METHODS:We examined 5554 patients from the VNS therapy Patient Outcome Registry, and also performed a systematic review of the literature including 2869 patients across 78 studies.RESULTS:Registry data revealed a progressive increase over time in seizure freedom after VNS therapy. Overall, 49% of patients responded to VNS therapy 0 to 4 months after implantation (≥50% reduction seizure frequency), with 5.1% of patients becoming seizure-free, while 63% of patients were responders at 24 to 48 months, with 8.2% achieving seizure freedom. On multivariate analysis, seizure freedom was predicted by age of epilepsy onset >12 years (odds ratio “OR”, 1.89; 95% confidence interval “CI”, 1.38-2.58), and predominantly generalized seizure type (OR, 1.36; 95% CI, 1.01-1.82), while overall response to VNS was predicted by nonlesional epilepsy (OR, 1.38; 95% CI, 1.06-1.81). Systematic literature review results were consistent with the registry analysis: At 0 to 4 months, 40.0% of patients had responded to VNS, with 2.6% becoming seizure-free, while at last follow-up, 60.1% of individuals were responders, with 8.0% achieving seizure freedom.CONCLUSION:Response and seizure freedom rates increase over time with VNS therapy, although complete seizure freedom is achieved in a small percentage of patients.

Sign in / Sign up

Export Citation Format

Share Document