Abstracts

RATIONALE: The Vagus Nerve Stimulation (VNS) represents a treatment method for patients with intractable focal or symptomatic generalized epilepsies. At the epilepsy center of the University of Greifswald 33 patients have been implanted with a Neurocybernetic Prosthesis System TM. We present our clinical results of 26 patients observed for a period of 1 to 3 years after implantation.
METHODS: Twenty six patients (age of 12-53 years) have been implanted, including patients with intractable non-operable focal epilepsies, patients with intractable unsuccesfully operated focal epilepsies and refractory Lennox Gastaut Syndroms. The parameters of stimulation concerning standard parameters varied individually between 0.25-3.5mA, in case of rapid cycle parameters between 0.25-1.25mA. A change of the antiepileptic drug treatment was undertaken only in case of clinical indications.
RESULTS: One year after implantation (26 patients) a reduction of the seizure frequency was realised in 46.1% ([gt]20% n=8, [gt]50% n=3, [gt]75% n=1). After 2 years (19 patients) the reduction of the seizure frequency was observed in 47.4% ([gt]20% n=3, [gt]50% n=4, [gt]75% n=2). The highest rate of seizure reduction was found after 3 years (6 patients) of treatment with 66.7% ([gt]20% n=1, [gt]50% n=2, [gt]75% n=1). Further results were noticed in the form of extension of the seizure free period, in the form of reduction of the seizure intensity, -duration and period of reorientation. The quality of life has been improved. Side effects such as hoarseness, coughing, voice alteration, pain, paresthesia and dyspnea were rare. In two patients the VNS had to be removed.
CONCLUSIONS: Our results confirm that the VNS represents a supplementary treatment which is as effective as the new antiepileptic drugs. The VNS is characterized by a good tolerance. Interactions with antiepileptic drugs and problems with patients-compliance have not yet been observed. We confirm the good results of the VNS presented by other centers of epilepsy.