Abstracts

Rationale: In the last decades VNS therapy became an accepted safe and effective palliative treatment for both children and adults with partial or generalized refractory epilepsy that are not candidates for resection, disconnection or even for those patients who fail in controlling seizures after surgical treatment. In addition to the reduction of the frequency and intensity of the seizures, there is evidence that VNS therapy improves attention, cognition, behaviour, humor, memory and quality of life. The present abstract describes the results of the VNS therapy in eight patients with refractory epilepsy. Methods: Retrospective analysis of eight patients (four females), mean age from 3 to 32 years, with refractory epilepsy from different ethiologies (West Syndrome, Tuberous Sclerosis, post infection and post resection) and with negative impact in quality of life. Pre-surgical seizure frequency ranged from 10 to 40 seizures/day. All patients underwent complete pre-surgical investigation. Only one patient had undergone previous left mesial temporal lobectomy four years before VNS implantation. Follow up ranged from 6 to 44 months. VNS adjustment was individualized and performed in a slow and gradual fashion. Primary outcome was reduction in frequency, intensity and duration of seizures. Results: One patient remained seizure-free for 12 months. After that, seizures returned, and together with another patient, seizure frequency remains about 10% compared to pre-surgical. In five patients seizure frequency was reduced in about 70% and in one patient seizure frequency was reduced in about 40% compared to pre-surgical. All patients showed improvement in quality of life related to the reduction in seizure frequency after VNS therapy. Only one patient had transitory and not disabling hoarseness of voice. There were no deaths related to VNS. Conclusions: Our small experience seems to confirm that VNS therapy is an alternative effective, safe and well tolerated treatment for patients with refractory epilepsy not candidates for resection, disconnection or even for those who fail in controlling seizures after previous surgical treatment. Funding: None.