Efficacy and safety of using vagus nerve stimulation in patients with pharmacoresistant epilepsy in the Russian Federation: a multi-center retrospective observational program

Objective: to assess efficacy and safety of vagus nerve stimulation (VNS) in patients with pharmacoresistant epilepsy.Material and methods. A multi-center retrospective observational program was applied in patients with pharmacoresistant epilepsy by using vagus nerve stimulation for at least 2 years. There were enrolled 151 subjects, patient age on stimulator implantation varied from 5 to 65 years (24.4±13.1 years). Among them, subjects under 18 or at least 18 years of age comprised 58 (38.4%) and 93 (61.6%), respectively. Changes in rate and severity of major group epileptic seizures (highly disabling type) 24 months after VNS-therapy vs. baseline state as well as during 3-, 6-, 9-, 12-month follow-up were compared. There were assessed stimulator-related effects on VNS-therapy as well as patient quality of life 2 years after therapy. The dynamics of the frequency of all types of epileptic seizures was evaluated according to McHugh Outcome scale.Results. Mean epilepsy duration on stimulator implantation was 170.9±126.8 months, with maximum up to 666 months (55 years). Number of patients with dominant (disabling) seizures on implantation procedure comprised 136 (90.1%). Decline in dominant epileptic seizure rate by 50–99% was recorded in 91 patients (66.9%) 24 months after VNStherapy. Among such subjects were 41 patients (30.15%) featured with disabling seizures including 24 fully seizure free subjects (17.65%). Decreased rate of all group epileptic seizures by more than 50% (responders) was found in 52.9% cases, including subjects under 18 and adults in 63.9% and as few as 46.3% (p<0.05), respectively. While assessing dynamic rate for all groups of epileptic seizures applied with VNS-therapy by using McHugh Outcome scale it was found that class I (lowered seizure rate by 80–100%) was observed in 44 cases (29.1%), including 18 patients under 18 (31%) and 26 subjects above 18 (28%) (insignificant difference). Mean dominant group epileptic seizure rate was also significantly decreased in both age groups from 20 down to 5.7 per month. Severity of epileptic seizures and postseizure condition upon VNS-therapy was decreased in 38.6% and 43.9% patients 24 months after therapy and on final follow-up visit, respectively (more than 24 months after implantation). No serious adverse events as well as adverse effects resulting in therapy cancel were noted. Conclusion. Vagus nerve stimulation is an effective and safe auxiliary treatment method for therapy of pharmacoresistant epilepsy both in children and adults.><0.05) , respectively. While assessing dynamic rate for all groups of epileptic seizures applied with VNS-therapy by using McHugh Outcome scale it was found that class I (lowered seizure rate by 80–100%) was observed in 44 cases (29.1%), including 18 patients under 18 (31%) and 26 subjects above 18 (28%) (insignificant difference). Mean dominant group epileptic seizure rate was also significantly decreased in both age groups from 20 down to 5.7 per month. Severity of epileptic seizures and postseizure condition upon VNS-therapy was decreased in 38.6% and 43.9% patients 24 months after therapy and on final follow-up visit, respectively (more than 24 months after implantation). No serious adverse events as well as adverse effects resulting in therapy cancel were noted.Conclusion. Vagus nerve stimulation is an effective and safe auxiliary treatment method for therapy of pharmacoresistant epilepsy both in children and adults.

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Faculty Opinions recommendation of Chronic vagus nerve stimulation in Crohn's disease: a 6-month follow-up pilot study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726177952.793516880 ◽

2016 ◽

Author(s):

Adam Farmer

Keyword(s):

Crohn’S Disease ◽

Pilot Study ◽

Crohn's Disease ◽

Vagus Nerve ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation

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Prediction of Epileptic Seizures for On-Demand Vagus Nerve Stimulation

IFMBE Proceedings - 14th Nordic-Baltic Conference on Biomedical Engineering and Medical Physics ◽

10.1007/978-3-540-69367-3_78 ◽

2008 ◽

pp. 290-293 ◽

Cited By ~ 2

Author(s):

Kristian Rauhe Nielsen ◽

C. Sevcencu ◽

A. Rasmussen ◽

J. J. Struijk

Keyword(s):

Vagus Nerve ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Epileptic Seizures ◽

On Demand

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Vagus nerve stimulation may be a sound therapeutic option in the treatment of refractory epilepsy

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2013000100006 ◽

2013 ◽

Vol 71 (1) ◽

pp. 25-30 ◽

Cited By ~ 4

Author(s):

Murilo S. Meneses ◽

Samanta F. B. Rocha ◽

Cristiane Simão ◽

Heraldo Nei Hardt Laroca dos Santos ◽

Cleudi Pereira ◽

...

Keyword(s):

Vagus Nerve ◽

Seizure Frequency ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Palliative Treatment ◽

Refractory Epilepsy ◽

Therapeutic Option ◽

Treatment Objective

INTRODUCTION: Refractory epilepsy accounts for 20 to 30% of epilepsy cases and remains a challenge for neurologists. Vagus nerve stimulation (VNS) is an option for palliative treatment. OBJECTIVE: It was to study the efficacy and tolerability of VNS in patients implanted with a stimulator at the Curitiba Institute of Neurology (INC). METHODS: A case study of six patients with refractory epilepsy submitted to a VNS procedure at the INC in the last four years was described and discussed. RESULTS: Mean age at time of implantation was 29 years. Mean follow-up was 26.6 months. Seizure frequency decreased in all patients (40-50% (n=2) and >80% (n=4)). Three patients no longer required frequent hospitalizations. Two patients previously restricted to wheelchairs started to walk, probably because of improved mood. CONCLUSION: In this population, VNS proved to be a sound therapeutic option for treating refractory epilepsy.

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

Child s Nervous System ◽

10.1007/s00381-015-3004-z ◽

2016 ◽

Vol 32 (4) ◽

pp. 641-646 ◽

Cited By ~ 24

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

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Vagus Nerve Stimulation Paired With Upper-Limb Rehabilitation After Stroke: One-Year Follow-up

Neurorehabilitation and Neural Repair ◽

10.1177/1545968320924361 ◽

2020 ◽

Vol 34 (7) ◽

pp. 609-615

Author(s):

Jesse Dawson ◽

Navzer D. Engineer ◽

Cecília N. Prudente ◽

David Pierce ◽

Gerard Francisco ◽

...

Keyword(s):

Ischemic Stroke ◽

Vagus Nerve ◽

Upper Limb ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Exercise Program ◽

Home Exercise ◽

Home Exercise Program

Background. Vagus nerve stimulation (VNS) paired with rehabilitation may improve upper-limb impairment and function after ischemic stroke. Objective. To report 1-year safety, feasibility, adherence, and outcome data from a home exercise program paired with VNS using long-term follow-up data from a randomized double-blind study of rehabilitation therapy paired with Active VNS (n = 8) or Control VNS (n = 9). Methods. All people were implanted with a VNS device and underwent 6 weeks in clinic therapy with Control or Active VNS followed by home exercises through day 90. Thereafter, participants and investigators were unblinded. The Control VNS group then received 6 weeks in-clinic Active VNS (Cross-VNS group). All participants then performed an individualized home exercise program with self-administered Active VNS. Data from this phase are reported here. Outcome measures were Fugl-Meyer Assessment—Upper Extremity (FMA-UE), Wolf Motor Function Test (Functional and Time), Box and Block Test, Nine-Hole Peg Test, Stroke Impact Scale, and Motor Activity Log. Results. There were no VNS treatment–related serious adverse events during the long-term therapy. Two participants discontinued prior to receiving the full crossover VNS. On average, participants performed 200 ± 63 home therapy sessions, representing device use on 57.4% of home exercise days available for each participant. Pooled analysis revealed that 1 year after randomization, the FMA-UE score increased by 9.2 points (95% CI = 4.7 to 13.7; P = .001; n = 15). Other functional measures were also improved at 1 year. Conclusions. VNS combined with rehabilitation is feasible, with good long-term adherence, and may improve arm function after ischemic stroke.

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Follow - up of neuropediatric patients treated with vagus nerve stimulation

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.1922 ◽

2017 ◽

Vol 381 ◽

pp. 683

Author(s):

P.M. Preto Mimura ◽

I.B. Farias ◽

L. Seguti Ferreira ◽

A.L. Barbosa

Keyword(s):

Vagus Nerve ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation

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Older Age and Longer Epilepsy Duration Do Not Predict Worse Seizure Reduction Outcome after Vagus Nerve Stimulation

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0037-1607396 ◽

2017 ◽

Vol 79 (02) ◽

pp. 152-158 ◽

Cited By ~ 6

Author(s):

Jitka Kocvarova ◽

Zdenek Novak ◽

Irena Dolezalova ◽

Michal Svoboda ◽

Milan Brazdil ◽

...

Keyword(s):

Intellectual Disability ◽

Vagus Nerve ◽

Nerve Stimulation ◽

Vagus Nerve Stimulation ◽

Older Patients ◽

Age Groups ◽

Seizure Reduction ◽

Follow Up Care ◽

Patients With Epilepsy

Introduction We analyzed the results of vagus nerve stimulation (VNS) on older patients and patients with long-lasting epilepsy and included severely intellectually disabled patients. Patients and Methods A total of 103 adults with VNS implanted from 2005 to 2014 were studied. The responder rates, that is, the percentage of VNS patients who responded to VNS, classified as seizure reduction ≥ 50% (50R) and seizure reduction ≥ 90% (90R), were compared in defined age groups (< 40 and ≥ 40 years, and < 50 and ≥ 50 years) and epilepsy duration groups (< 20 and ≥ 20 years, < 30 and ≥ 30 years, and < 40 and ≥ 40 years) at the 1-year follow-up visit and the last follow-up visit (at least 2 years after surgery). The age distributions and responder rates were also studied in patients with an intellectual disability. Results The analysis did not confirm a significantly lower 50R or 90R rate in patients ≥ 40, ≥ 50, or ≥ 60 years when compared with their younger counterparts, but the 50R rate increase during follow-up care was the lowest in patients ≥ 50 and ≥ 60 years. The highest percentage of patients with an intellectual disability in the group < 40 years of age did not adversely affect the 50R rate. Longer epilepsy duration was not confirmed as a negative predictor of VNS outcome. There was a significantly higher 50R rate in patients with epilepsy duration ≥ 20 years (at the last follow-up visit) and a higher 90R rate in patients with epilepsy duration ≥ 30 years (at the 1-year follow-up visit). The increase in the 50R rate during follow-up care was lower in patients with epilepsy durations ≥ 30 and ≥ 40 years. Conclusions The study did not find worse VNS outcomes, as defined by the 50R or 90R rate, in older adult patients or in patients with a longer epilepsy duration. The increasing stimulation effect over time is less marked in older patients and in patients with longer epilepsy duration.

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