INTERIM RESULTS OF VAGUS NERVE STIMULATION EFFECTING QUALITY OF LIFE, SEIZURE CONTROL AND MEDICATION REDUCTION FOR DEVELOPMENTALLY DISABLED ADULTS WHO LIVE IN INSTITUTIONS
Abstract number :
2.433
Submission category :
Year :
2003
Submission ID :
4013
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Kara A. Kneedy-Cayem, Adam Mamelak, Roger L. Huf Epilepsy and Brain Mapping Center, Huntington Memorial Hospital, Pasadena, CA
Objective: This study was designed to measure and document to outcome of Vagus Nerve Stimulation on Quality of Life, seizure control and medication reduction for mentally retarded/developmentally disabled adults who live in institutions.
Background: Many MRDD patients are refractory seizure patients and therefore are on many different antiepileptic drugs (AED[apos]s) for seizure control. The side effects of these medications contribute to gross and fine motor impairment, negative cognitive and behavioral effect. Previous Studies of VNS therapy have shown improvement in patient quality of life following medication reduction.
Documentation was compiled showing outcomes for MRDD patients who live in long term care settings with pharmacoresistant epilepsy who were implanted with the VNS device 12 to 24 months previously.
Data was available for 40 patients ages 19 to 60 years at date of implant; one patient died 12 months after implantation. Seizure frequency decreased in 35 patients (88%), seizure duration was reduced in 31 (78%). Improvements were noted in alertness for 39 patients (98%), mood for 34 (85%), postictal period for 33 (83%), verbalization for 28 (70%), memory for 23 (58%), oral feeding for 19 (48%), school or day program for 19 (48%), gross motor skills for 19 (48%), attention span for 22 (55%), eye contact for 15 (38%), clarity of words for 11 (28%), word usage for 7 (18%), and bowel and bladder function for 6 (15%). Of the 125 antiepileptic drugs (AEDs) prescribed at baseline, 40 (32%) have been eliminated. Of the 40 patients, 33 (83%) have eliminated 1 or more AEDs, and 19 (48%) have reduced the dosage. As AEDs were being tapered and discontinued, dosage was increased for 5 patients (13%), and medication was added for 7 (18%). Diastat was prescribed at times, for break-through seizures during the titration.
It appears that VNS therapy has allowed better seizure control permitting a reduction and elimination of AEDs. This reduction of medications has improved various areas effecting quality of life for this difficult to treat population.
[Supported by: Cyberonics, Inc. Houston, Texas]