Abstracts

Vagus nerve stimulator was implanted as an alternative non pharmacological intervention in three patients with pharmacoresistant status epilepticus. Three patients were admitted to our institution whose status epilepticus failed to respond to standard pharmacotherapy. These patients were then emergently implanted with a VNS as an alternative to pharmacological therapy. On all three patients the VNS output current and duty cycle were adjusted frequently and final output current and duty cycle settings are shown in table 1. At our institution three patients were implanted with the VNS after they were diagnosed with pharmacoresistant status epilepticus. All three patients continue to have prolonged and repetitive electrographic and electroclinical seizures as documented by video EEG monitoring. There was complete resolution of status epilepticus in all three patients. Seizure frequency was reduced by [gt]60% in the first two patients and the third patient was completely seizure free. At the eighth week follow up visit post implantation, the families of the first two patients reported significant reduction in seizure frequency whereas the third patient experienced the return of seizures at four weeks post-implantation and reported significant reduction in seizures at the visit. In our patients, all three families reported increase in alertness and improvement in quality of life. Though these results are preliminary and we have discussed only three cases, they offer promising results and open a window of opportunity to perform prospective studies evaluating early use of VNS in patients whose status epilepticus has failed to respond to standard antiepileptic medication regimen. It would also be interesting to perform immediate and late cerebral blood flow studies in these patients to see if there are changes in flow volume after VNS implant.[table1][figure1]