Effect of Vagal Nerve Stimulation in Adults with Medically Refractory Generalized Epilepsy Syndromes.
Abstract number :
2.326
Submission category :
Year :
2001
Submission ID :
1956
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M.D. Holmes, MD, Neurology, University of Washington, Seattle, WA; D.L. Silbergeld, MD, Neurological Surgery, University of Washington, Seattle, WA; A.J. Wilensky, MD, PhD, Neurology, University of Washington, Seattle, WA; L.M. Ojemann, MD, Neurological S
RATIONALE: Vagal nerve stimulation (VNS) is effective in reducing seizure frequency in many patients with localization-related epilepsy syndromes. However, the efficacy of VNS in generalized epilepsy is less certain. The purpose of this study is to examine outcome following VNS in adults with well documented, medically refractory generalized epilepsy syndromes.
METHODS: 16 subjects with medically refractory, EEG-video documented generalized epilepsy (9 idiopathic, 7 symptomatic) were followed 12-21 months after implantation. Subjects ranged in age from 20-66 years. There were 9 men and 7 women. Duration of epilepsy before VNS ranged from 12-50 years. Seizure freqency at last followup was compared to a 3 month baseline. Antiepileptic drugs were held constant during the baseline period and after stimlator implantation.
RESULTS: At last followup, 8/16 patients (50%) had more than 50% reduction in seizures, while 3/16 (19%) had 20-49% reduction in seizures, 3/16 (19%)had no significant change in frequency and 2/16 (12%) had an increase in freqency of seizures. Overall, generalized tonc-clonic or tonic seizure types were the most likely to respond to VNS. Adverse events (AEs) included post-operative hoarseness, cough, swelling, or pain. Most AEs resolved after several weeks.
CONCLUSIONS: VNS is effective in producing a meaningful reduction in seizure frequency in many adults with medically refractory generalized epilepsy syndromes. AEs are usually mild, transient, and similar to what has been reported in other patients treated with VNS.
Disclosure: Grant - Cyberonics