Dilemmas in early implantation of vagus nerve stimulation in patients with drug resistant epilepsy and depression - our experience
EANS Academy. Nemir J. 09/26/19; 276166; EP07044
Dr. Jakob Nemir
Dr. Jakob Nemir

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Background: VNS is a viable minimally invasive neurosurgical treatment option in drug resistant epilepsy and depression. In patients with drug resistant epilepsy polytherapy is necessary, that emphasizes greater incidence of side effects which further impair quality of life (QOL) on physical, psychosocial and neurocognitive level.The diagnosis of depression in patients with epilepsy, confirmed by psychiatric assessment, should be better understood when making a decision for early treatment with VNS. Considering the fact that QOL is known to be strongly linked to mood and improvement in the Beck Depression Inventory scores, and following published VNS studies in epilepsy that assessed the quality of life, we performed a study of QOL on a group of patients with drug resistant epilepsy treated in the University Hospital Centre Zagreb who had undergone VNS implantation.
Methods: The study included 27 patients with drug resistant epilepsy with implanted VNS - case group (14M, 13F; mean age 34.7 +/-28.3years) and 18 controls - patients with drug resistant epilepsy without implanted VNS (10M, 8F; mean age 45.2 +/- 30.8 years). The quality of life was examined using the questionnaires 'Quality of life in epilepsy' (QOLIE-31 validated Croatian 1.0 version) and 'Beck Depression Inventory I' (BDI I validated Croatian version).For statistical analysis nonparametric Mann-Whitney test for independent samples was used. The study was approved by the Ethical Committee of the University Hospital Centre Zagreb.
Results: The Mann-Whitney test showed significant difference in the QoLIE-31 score between the case and the control group (p=0.041). In the case group we have noticed that younger patients had lower score of QoLIE-31 and higher score of BDI-I then the older ones.
Conclusion: Our results show positive influence on the quality of life and mood improvement following VNS implantation in patients with drug resistant epilepsy.
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