Refractory Status Epilepticus in Genetic Epilepsy-Is Vagus Nerve Stimulation an Option?
Specchio N, Ferretti A, Pietrafusa N, Trivisano M, Calabrese C, Carfì Pavia G, De Benedictis A, Marras CE, de Palma L, Vigevano F.
Front Neurol. 2020 Jun 12;11:443.
https://doi.org/10.3389/fneur.2020.00443
Continuing the theme of refractory and super refractory status epilepticus (#RSE and #SRSE) this #retrospectivecase report by Specchio et al. from 2020 describes 2 patients (age: 6 months and 16 years) with #genetic epilepsy and an ongoing SRSE that were successfully treated with acute vagus nerve stimulation (#VNS) implantation.
Highlights
• Successful interruption of SRSE following VNS implantation in two reported cases of genetic epilepsy
• No changes in antiseizure medication post VNS implantation
• Rapid titration of VNS output current
The patients had suffered from SRSE for 25 and 58 days respectively before VNS implantation. During this period, first line and second line antiseizure medictaion, as well as ketogenic diet in one patient, were employed without result.
Rapid titration of VNS output current was employed for both patients and successfully led to the termination of SRSE (at day 7 and day 10 post VNS insertion for the two patients respectively). At cessation of SRSE, the output current was 1.00 mA for the infant and 1.75 mA for the adolescent. Noteworthy, no changes in antiseizure medications were performed post VNS implantation.
Based on the current results, VNS Therapy appears to be a valid and safe treatment option for the termination of SRSE in patients with genetic epilepsy.