Long-term outcomes and prognosis factors of vagus nerve stimulation in patients with refractory epilepsy

AdultPediatric

Jan 18

Cuiping X, Hua L, Jiwen X, Xiaohua Z, Guiliang H, Qiang Qiang L, Chengyun D, Shan W, Quanjun Z, Xiaojun B, Kui C, Duanyu N, Yongjie L, Tao Y, Yuping W.

Acta Epileptologica 4, 38 (2022).
https://doi.org/10.1186/s42494-022-00109-w

Check out this multi-center, #retrospective study by Xu et al. (Sep. 2022) examining the long-term outcomes of vagus nerve stimulation (#VNS) in patients with drug-resistant epilepsy (#DRE).

This 4-year follow-up study included 76 patients (including 34 pediatric patients) who underwent VNS implantation at one out of five different epilepsy centers. The mean age at epilepsy onset, and at VNS implantation, was 8.51± 6.92 years (range: 0.1-31 years) and 21.40 ± 9.09 years (range: 6-40 years), respectively. 23 patients had a history of epilepsy surgery. The percentages of patients with partial seizures and generalized seizures were 43.4% and 15.8%, respectively.

The responder rate (defined as a ≥ 50% reduction in #seizure frequency) improved over time, with a 40.0%, 55.9%, 63.2%, and 68.4% responder rate at 6 months, 1 year, 3 years, and 4 years, respectively. Five patients were seizure-free at the 3-year and 4-year follow-ups. Furthermore, 36 adult patients answered a quality of life (#QoL) questionnaire during the 1-year follow-up. Significant improvements were found in seizure worry, social function, cognition, and overall scores (Figure 1).

Noteworthy, a comparison of outcomes among patients with tonic and generalized tonic-clonic seizures demonstrated that the outcomes favored patients with tonic seizures (p = 0.026).

In conclusion, this study provides long-term follow-up clinical evidence for VNS treatment in patients with DRE. The results demonstrated that VNS is an effective treatment for DRE patients who failed to achieve seizure control through epilepsy surgery.