Abstracts

Rationale: Vagus Nerve Stimulation (VNS) Therapy is a broad spectrum treatment for medically refractory epiîlepsy when epilepsy surgery is not an option or has failed. Methods: Eleven patients (6 M, 5 F) with refractory epilepsy and history of brain tumor were retrospectively selected from the Cyberonics International Patient Registry. Mean age was 33.8 ± 12.60 years (median 34; range 12-58). Mean age at onset of epilepsy was 19.2 ± 15.77 years (median 11; range, 1-48). Nine patients had partial epilepsy (6 temporal, 2 frontal; 1 temporal and frontal) and 2 patients had generalized epilepsy. Tumor type: neuroblastoma, N=2; oligodendroglioma, N=1; meningioma, N=2; astrocytoma, N=4; ganglioglioma, N=2. Six patients had prior epilepsy surgery: five had a history of lobectomy and one of multiple subpial transection. Co-morbidities: depression, N=3; behavioral problems, N=2; learning disabilities, N=1. Mean follow-up was 37.3 ± 13.43 months (median 40; range, 7-60). Results: Mean seizure reduction: 38.7%; median seizure reduction: 63.0%. No difference in response occurred for patients with malignant tumors (p=0.2364) or extra axial tumors (p=0.4904). Quality of life (“better” or “much better”): alertness, N=7; post-ictal, N=7; clusters of seizures, N=7; verbal communication, N=6; memory, N=6; mood, N=6; school/professional achievements, N=4. For 7/9 patients, the magnet was “always” or “most of the time” effective. Conclusions: Adjunctive VNS Therapy was associated with mean and median seizure reduction of 39% and 63%, respectively, and with important quality of life improvements in this group of patients with refractory epilepsy associated with a history of brain tumor.