Improved quality of life and cognition after early vagal nerve stimulator implantation in children

Pediatric

May 18

Soleman J, Stein M, Knorr C, Datta AN, Constantini S, Fried I, Guzman R, Kramer U.
Epilepsy & Behavior 88 (2018) 139–145
http://ow.ly/k1Tf50JaUYi

Continuing on our #early vagus nerve stimulation (#VNS) implantation theme, we would like to highlight a #retrospective study by Soleman et al. 2018, assessing the outcomes of early use of VNS in children with drug-resistant epilepsy (#DRE). The study aimed to compare #seizure outcomes, quality of life (#QoL), and #cognition between DRE patients undergoing early (age: ≤5 yr) and late (age: >5 yr) implantation.

Highlights

● Early use of VNS Therapy can significantly improve QoL and cognition in children with DRE.

● Early VNS implantation in pediatric patients with DRE improves parents’ satisfaction.

● VNS Therapy should be considered as early as possible for DRE patients under the age of five.

45 children were enrolled in this study, 14 (31.1%) patients were undergoing early implantation of VNS, while 31 (68.9%) patients underwent late implantation. The early implantation group had a significantly shorter duration (31.6±15.3 months) between seizure onset and VNS implantation compared to that of the late group (153.9±196.7 months, P<0.001). The mean #follow-up time was 72.3 months. Outcomes of VNS Therapy, including reduction of seizure frequency and improvements in QoL, were assessed by the McHugh classification, Engel classification, Pediatric Quality of Life (#PEDSQL™) questionnaire, and the caregiver impression (#CGI) scale, respectively.

The results showed that the early implantation group had a higher mean reduction in seizure frequency. Moreover, the early implantation group showed significantly better results on CGI scales, total PEDSQL™ Core scores, and cognitive PEDSQL™ Core scores (P = 0.004, 0.01, and 0.03, respectively), suggesting a correlation between early implantation of VNS and improvements in QoL.

The study provided clinical evidence that early use of VNS Therapy can significantly improve QoL, cognition, and parents’ satisfaction for pediatric patients with DRE. Based on the current result, VNS Therapy should be considered as a treatment for DRE as early as possible for patients younger than five years of age.