10-year follow-up results of vagus nerve stimulation in refractory epilepsy – what happened to the patients?
EANS Academy. Vaz da Silva F. 10/04/21; 339382; EP08017
Filipe Vaz da Silva
Contributions
Contributions
Abstract
Epilepsy may be refractory in up to 30% of patients and vagus nerve stimulator (VNS) is a valuable alternative treatment. Few studies describe VNS outcomes 5 years after surgery.
The aim of this study was to determine the effect of VNS in refractory epilepsy (RE) control and to evaluate clinical outcome and complications associated with VNS, 10 years after its implantation.
A retrospective study of patients with RE and VNS implanted between 2000 and 2011 was conducted. Seizure frequency and duration; abolition of fall events; antiepileptic drug reduction; VNS related complications; global clinical impression; satisfaction status and other relevant benefits regarding demographic data, seizure type and epilepsy etiology were analysed.
We identified 73 patients (median age at surgery 26.36±12.64 years old, range 7-66 years old), 43 of them were male (58.9%). In the 10-year follow-up, 35 patients (47.9%) had structural etiology, 45 patients (61.6%) had syndromic condition and 32 patients (43.8%) had unclassified or mixed seizures. No intraoperative complications were registered and dysphonia was the most common postoperative complication (20.5%). During follow-up period, 7 patients (9.6%) died.
At 10-year follow-up, 40% of patients had seizure reduction≥50%, 54.5% had engel classification≤3, 28.8% had abolition of fall events and 9.1% were able to reduce antiepileptic drugs, 54.5% of patients had global clinical impression–improvement scale≥3 and 48.5% were satisfied with ENV implantation.
After multivariate analysis, syndromic paediatric population had significant seizure reduction≥50% (p=0.018). Syndromic adult population had significant Engel classification≤3 (p=0.05) and showed a trend to abolition of fall events (p=0.061) and global clinical impression-improvement scale≥3 (p=0.061). Despite the age, patients were significantly satisfied with ENV implantation (p<0.001).
VNS is a valid option with long-term benefit in RE in terms of seizures, clinical outcome and patient satisfaction.
The aim of this study was to determine the effect of VNS in refractory epilepsy (RE) control and to evaluate clinical outcome and complications associated with VNS, 10 years after its implantation.
A retrospective study of patients with RE and VNS implanted between 2000 and 2011 was conducted. Seizure frequency and duration; abolition of fall events; antiepileptic drug reduction; VNS related complications; global clinical impression; satisfaction status and other relevant benefits regarding demographic data, seizure type and epilepsy etiology were analysed.
We identified 73 patients (median age at surgery 26.36±12.64 years old, range 7-66 years old), 43 of them were male (58.9%). In the 10-year follow-up, 35 patients (47.9%) had structural etiology, 45 patients (61.6%) had syndromic condition and 32 patients (43.8%) had unclassified or mixed seizures. No intraoperative complications were registered and dysphonia was the most common postoperative complication (20.5%). During follow-up period, 7 patients (9.6%) died.
At 10-year follow-up, 40% of patients had seizure reduction≥50%, 54.5% had engel classification≤3, 28.8% had abolition of fall events and 9.1% were able to reduce antiepileptic drugs, 54.5% of patients had global clinical impression–improvement scale≥3 and 48.5% were satisfied with ENV implantation.
After multivariate analysis, syndromic paediatric population had significant seizure reduction≥50% (p=0.018). Syndromic adult population had significant Engel classification≤3 (p=0.05) and showed a trend to abolition of fall events (p=0.061) and global clinical impression-improvement scale≥3 (p=0.061). Despite the age, patients were significantly satisfied with ENV implantation (p<0.001).
VNS is a valid option with long-term benefit in RE in terms of seizures, clinical outcome and patient satisfaction.
Epilepsy may be refractory in up to 30% of patients and vagus nerve stimulator (VNS) is a valuable alternative treatment. Few studies describe VNS outcomes 5 years after surgery.
The aim of this study was to determine the effect of VNS in refractory epilepsy (RE) control and to evaluate clinical outcome and complications associated with VNS, 10 years after its implantation.
A retrospective study of patients with RE and VNS implanted between 2000 and 2011 was conducted. Seizure frequency and duration; abolition of fall events; antiepileptic drug reduction; VNS related complications; global clinical impression; satisfaction status and other relevant benefits regarding demographic data, seizure type and epilepsy etiology were analysed.
We identified 73 patients (median age at surgery 26.36±12.64 years old, range 7-66 years old), 43 of them were male (58.9%). In the 10-year follow-up, 35 patients (47.9%) had structural etiology, 45 patients (61.6%) had syndromic condition and 32 patients (43.8%) had unclassified or mixed seizures. No intraoperative complications were registered and dysphonia was the most common postoperative complication (20.5%). During follow-up period, 7 patients (9.6%) died.
At 10-year follow-up, 40% of patients had seizure reduction≥50%, 54.5% had engel classification≤3, 28.8% had abolition of fall events and 9.1% were able to reduce antiepileptic drugs, 54.5% of patients had global clinical impression–improvement scale≥3 and 48.5% were satisfied with ENV implantation.
After multivariate analysis, syndromic paediatric population had significant seizure reduction≥50% (p=0.018). Syndromic adult population had significant Engel classification≤3 (p=0.05) and showed a trend to abolition of fall events (p=0.061) and global clinical impression-improvement scale≥3 (p=0.061). Despite the age, patients were significantly satisfied with ENV implantation (p<0.001).
VNS is a valid option with long-term benefit in RE in terms of seizures, clinical outcome and patient satisfaction.
The aim of this study was to determine the effect of VNS in refractory epilepsy (RE) control and to evaluate clinical outcome and complications associated with VNS, 10 years after its implantation.
A retrospective study of patients with RE and VNS implanted between 2000 and 2011 was conducted. Seizure frequency and duration; abolition of fall events; antiepileptic drug reduction; VNS related complications; global clinical impression; satisfaction status and other relevant benefits regarding demographic data, seizure type and epilepsy etiology were analysed.
We identified 73 patients (median age at surgery 26.36±12.64 years old, range 7-66 years old), 43 of them were male (58.9%). In the 10-year follow-up, 35 patients (47.9%) had structural etiology, 45 patients (61.6%) had syndromic condition and 32 patients (43.8%) had unclassified or mixed seizures. No intraoperative complications were registered and dysphonia was the most common postoperative complication (20.5%). During follow-up period, 7 patients (9.6%) died.
At 10-year follow-up, 40% of patients had seizure reduction≥50%, 54.5% had engel classification≤3, 28.8% had abolition of fall events and 9.1% were able to reduce antiepileptic drugs, 54.5% of patients had global clinical impression–improvement scale≥3 and 48.5% were satisfied with ENV implantation.
After multivariate analysis, syndromic paediatric population had significant seizure reduction≥50% (p=0.018). Syndromic adult population had significant Engel classification≤3 (p=0.05) and showed a trend to abolition of fall events (p=0.061) and global clinical impression-improvement scale≥3 (p=0.061). Despite the age, patients were significantly satisfied with ENV implantation (p<0.001).
VNS is a valid option with long-term benefit in RE in terms of seizures, clinical outcome and patient satisfaction.
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