Vagus nerve stimulation after failed surgical treatment of drug-resistant epilepsy
EANS Academy. Trifonov I. 10/04/21; 339115; EP08012
Dr. Igor Trifonov
Contributions
Contributions
Abstract
Purpose: to evaluate the effectiveness of vagus nerve stimulation (VNS) after failed resective epilepsy surgery.
Method: 52 patients with drug-resistant epilepsy were implanted VNS in the period from 01.01.2016 to 31.12.2020. Before 37 (14 men and 23 women) patients underwent resective epilepsy surgery. The outcomes of VNS were assessed using the modified J. Engel classification (I: seizure-free/rare simple partial seizures; II: >90% seizure reduction (SR), III: 50-90% SR, IV: <50% SR; classes I to III (>50% SR) = favorable outcome).
Results:The patient's average year old was 33,29 years, the average age of onset of the disease was 9,75 years, the duration of the epilepsy was 24,0 years. All patients in this group previously had resective surgery. 22 patients (59,5%) were successfully interviewed, 10 (27%) - refusal to communicate, 5 patients did not meet the outcome date (13,5%). The outcomes of the VNS were assessed after 6,12,36 months using the modified J. Engel classification (table 1).
There was no surgical mortality. Side effects of VNS: hoarseness -9 (40,9%) ,cough – 5 (22,7%),discomfort and pain in the throat-5 (22,7%), discomfort and pain in the neck and chest-2 (9%), asphyxia-1 (4,5%) (VNS later-disabled).
Conclusion: we confirmed the effectiveness VNS therapy in patients who failed resective epilepsy surgery in our series: 62,5 % patients had favorable outcome after 6 months of observation, 72,5% - after 12 months and 59,6% - after 36 months. Currently, the field of VNS continues to be explored, as well as the rationality of its use after failed surgical treatment.
Method: 52 patients with drug-resistant epilepsy were implanted VNS in the period from 01.01.2016 to 31.12.2020. Before 37 (14 men and 23 women) patients underwent resective epilepsy surgery. The outcomes of VNS were assessed using the modified J. Engel classification (I: seizure-free/rare simple partial seizures; II: >90% seizure reduction (SR), III: 50-90% SR, IV: <50% SR; classes I to III (>50% SR) = favorable outcome).
Results:The patient's average year old was 33,29 years, the average age of onset of the disease was 9,75 years, the duration of the epilepsy was 24,0 years. All patients in this group previously had resective surgery. 22 patients (59,5%) were successfully interviewed, 10 (27%) - refusal to communicate, 5 patients did not meet the outcome date (13,5%). The outcomes of the VNS were assessed after 6,12,36 months using the modified J. Engel classification (table 1).
| Engel | After 6 mo (n=8) | After 12 mo.(n=8) | After 36 mo. (n=6) |
| I | 2 (25%) | 1 (12,5%) | 1 (16,7%) |
| II | 1 (12,5%) | 0 | 0 |
| III | 2 (25%) | 4 (50%) | 3 (42,9%) |
| IV | 3 (37,5%) | 3 (37,5%) | 2 (33,4%) |
There was no surgical mortality. Side effects of VNS: hoarseness -9 (40,9%) ,cough – 5 (22,7%),discomfort and pain in the throat-5 (22,7%), discomfort and pain in the neck and chest-2 (9%), asphyxia-1 (4,5%) (VNS later-disabled).
Conclusion: we confirmed the effectiveness VNS therapy in patients who failed resective epilepsy surgery in our series: 62,5 % patients had favorable outcome after 6 months of observation, 72,5% - after 12 months and 59,6% - after 36 months. Currently, the field of VNS continues to be explored, as well as the rationality of its use after failed surgical treatment.
Purpose: to evaluate the effectiveness of vagus nerve stimulation (VNS) after failed resective epilepsy surgery.
Method: 52 patients with drug-resistant epilepsy were implanted VNS in the period from 01.01.2016 to 31.12.2020. Before 37 (14 men and 23 women) patients underwent resective epilepsy surgery. The outcomes of VNS were assessed using the modified J. Engel classification (I: seizure-free/rare simple partial seizures; II: >90% seizure reduction (SR), III: 50-90% SR, IV: <50% SR; classes I to III (>50% SR) = favorable outcome).
Results:The patient's average year old was 33,29 years, the average age of onset of the disease was 9,75 years, the duration of the epilepsy was 24,0 years. All patients in this group previously had resective surgery. 22 patients (59,5%) were successfully interviewed, 10 (27%) - refusal to communicate, 5 patients did not meet the outcome date (13,5%). The outcomes of the VNS were assessed after 6,12,36 months using the modified J. Engel classification (table 1).
There was no surgical mortality. Side effects of VNS: hoarseness -9 (40,9%) ,cough – 5 (22,7%),discomfort and pain in the throat-5 (22,7%), discomfort and pain in the neck and chest-2 (9%), asphyxia-1 (4,5%) (VNS later-disabled).
Conclusion: we confirmed the effectiveness VNS therapy in patients who failed resective epilepsy surgery in our series: 62,5 % patients had favorable outcome after 6 months of observation, 72,5% - after 12 months and 59,6% - after 36 months. Currently, the field of VNS continues to be explored, as well as the rationality of its use after failed surgical treatment.
Method: 52 patients with drug-resistant epilepsy were implanted VNS in the period from 01.01.2016 to 31.12.2020. Before 37 (14 men and 23 women) patients underwent resective epilepsy surgery. The outcomes of VNS were assessed using the modified J. Engel classification (I: seizure-free/rare simple partial seizures; II: >90% seizure reduction (SR), III: 50-90% SR, IV: <50% SR; classes I to III (>50% SR) = favorable outcome).
Results:The patient's average year old was 33,29 years, the average age of onset of the disease was 9,75 years, the duration of the epilepsy was 24,0 years. All patients in this group previously had resective surgery. 22 patients (59,5%) were successfully interviewed, 10 (27%) - refusal to communicate, 5 patients did not meet the outcome date (13,5%). The outcomes of the VNS were assessed after 6,12,36 months using the modified J. Engel classification (table 1).
| Engel | After 6 mo (n=8) | After 12 mo.(n=8) | After 36 mo. (n=6) |
| I | 2 (25%) | 1 (12,5%) | 1 (16,7%) |
| II | 1 (12,5%) | 0 | 0 |
| III | 2 (25%) | 4 (50%) | 3 (42,9%) |
| IV | 3 (37,5%) | 3 (37,5%) | 2 (33,4%) |
There was no surgical mortality. Side effects of VNS: hoarseness -9 (40,9%) ,cough – 5 (22,7%),discomfort and pain in the throat-5 (22,7%), discomfort and pain in the neck and chest-2 (9%), asphyxia-1 (4,5%) (VNS later-disabled).
Conclusion: we confirmed the effectiveness VNS therapy in patients who failed resective epilepsy surgery in our series: 62,5 % patients had favorable outcome after 6 months of observation, 72,5% - after 12 months and 59,6% - after 36 months. Currently, the field of VNS continues to be explored, as well as the rationality of its use after failed surgical treatment.
{{ help_message }}
{{filter}}