Abstracts

RATIONALE:To assess the safety and efficacy of vagus nerve stimulation in children affected by Partial Drug-resistant Symptomatic or Cryptogenic Epilepsy . METHODS:_Eight children (4 M, 4 F) , age range 4-17 years, underwent vagal nerve stimulation. All children were affected by multiple seizure types with a frequency ranged from 10 per month to 40 per day. The main duration of epilepsy was 9 years (range 4-16 years). All patients had failed politherapy with more antiepileptic drugs, including new ones, and all had moderate/severe cognitive impairment. Interictal EEG showed focal abnormalities in the frontal or temporal regions with important secondary bilateral synchronism in all cases. The surgical procedure takes 60-90 minutes. Because most patients were thin, the stimulator is placed deeply in a pocket between the fascia of muscles pectoralis major and minor to avoid skin necrosis and reduce the chest bulging. Ten days after the surgical procedure, we activated the stimulator and the ramping up process to reach 2 mA for 30 sec every 5 minutes started. Patients were assessed for seizure count, safety and quality of life after three,six and twelve months. RESULTS: _Six months after the implantation, the Results analysis is still understudyng , anyway there are some interesting data can be outlined : ??No serious adverse events appeared after surgical procedure: mild throatness occurred in one child , a change in voice,when battery is on, did not adversely affected these patients. ??Five patients had a significant improvement in seizure frequency ( 50% in two, 75% in one and 90% in two). The improvement started early, during the ramping up process. ??Six patients experienced a reduction in seizure intensity. ??Six patients reported improvement in overall disposition, behavior, mood, attention and school performance. CONCLUSIONS: The intermittent vagal nerve stimulation appears a safe, feasible and potentially effective method of reducing seizures in select pediatric epileptic patients.