EFFICACY OF VAGUS NERVE STIMULATION IN PATIENTS ON UNCHANGED DOSE OF ANTIEPILEPTIC DRUG REGIMEN: 2 YEAR OUTCOME AT A COMMUNITY BASED COMPREHENSIVE EPILEPSY CENTER
Abstract number :
1.257
Submission category :
8. Non-AED/Non-Surgical Treatments (Hormonal, ketogenic, alternative, etc.)
Year :
2012
Submission ID :
16338
Source :
www.aesnet.org
Presentation date :
11/30/2012 12:00:00 AM
Published date :
Sep 6, 2012, 12:16 PM
Authors :
S. Chayasirisobhon, L. Cahan, S. Choi, B. Enos, J. Hwang, M. Lin, J. Schweitzer, B. Spurgeon, E. Stuckert, S. Gurbani,
Rationale: To establish long term persistent efficacy of vagus nerve stimulation (VNS) for the adjunctive treatment of intractable epilepsy (failed at least 3 appropriate drugs) in the patients on unchanged antiepileptic drug (AED) regimen. Methods: We conducted epilepsy treatment outcome analysis of clinical data of 39 consecutive patients with VNS implant whose AED regimen was unchanged for a period of 24 months following the VNS implant surgery. The efficacy of VNS therapy was evaluated at 6 months, 12 months and 24 months. Results: Of the 39 patients, 24 (61.5 %) at 6 months, 25 (64.1 %) at 12 months and 25 (64.1 %) at 24 months showed ≥50% reduction in seizure frequency. Nineteen (48.7 %) patients had ≥50% reduction in seizure frequency in all three periods. Partial response was seen in 10 (25.6 %) patients. Ten patients (25.6%) showed no clinically significant benefit in all three periods. A complete (100%) seizure control at 6 months, 12 months and 24 months was seen in 2 (5.1%), 7 (17.9 %) and 8 (20.5%) patients respectively. We analyzed the efficacy of VNS for different types of seizures in three study periods. Out of 39 patients, 23 patients had partial seizures with and without secondary generalized seizures, and 16 patients had primary generalized types of seizures. Twelve (52.2%) of the 23 patients with partial seizures showed ≥ 50% reduction of seizure frequency. Seven (43.8%) of the 16 patients with generalized types of seizures showed ≥ 50% reduction of seizure frequency. VNS therapy was tolerated well with no patient requiring discontinuation of therapy. Conclusions: 1) Patients with unchanged AED regimen on VNS therapy had persistent seizure control lasting for 24 months. 2) Number of patients achieving complete seizure control increased with increasing duration of VNS therapy. 3) No major complications or side effects requiring discontinuation of therapy were noted. Our experience supports the persistent efficacy and safety of long-term adjunctive VNS therapy in treatment of intractable epilepsy.
Non-AED/Non-Surgical Treatments