Searching for Biomarkers of Better Responses of VNS Therapy
Abstract number :
3.334
Submission category :
9. Surgery / 9C. All Ages
Year :
2021
Submission ID :
1825670
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
Francisco Arruda, MD, PhD - Instituto de Neurologia de Goiania; Helio van der Linden, MD - Instituto de Neurologia de Goiânia; Paulo Ragazzo, MD, PhD - Instituto de Neurologia de Goiânia
Rationale: Vagal Nerve Stimulation (VNS) has been a valuable addition to the therapeutic arsenal in epilepsy. With over 100.000 patients implanted worldwide, there is still question about which types of patients can benefit most. This study compares the results of VNS therapy in a series of 87 patients from a single epilepy treatment center in Brazil, categorized as focal, multifocal, hemispheric, bilateral or generalized, aiming to identify differences in the results as groups.
Methods: Eighty-seven patients were followed prospectively after VNS implantation according to the "Liga Brasileira de Epilepsia" guidelines. Baseline pre-implant mean seizure frequency was confronted to each post-implant visit and recorded. Patients were grouped according to topographic diagnosis and subgrouped by etiology. Previously operated patients were also included in the analysis. Reduction in seizure frequency was rated as (1) less than 50%; (2) between 50 and 75%; and (3) over 75%. A minimum of 12 months of therapy was required for the study.
Results: Overall results showed significant improvement of seizure control, with 80% of patients achieving at least 50% of seizure reduction and 45% with greater than 75% reduction. The group of better responses was the non-lesional focal epilepsies, followed by mesial temporal sclerosis cases. Significant improvements were also recorded in post-traumatic epilepsies and focal disorders of cortical development. Non-lesional generalized epilepsies presented a curious dichotomy, with either no significant or very significant improvement, with few patients falling inbetween.
Conclusions: There is no question about the efficacy of VNS therapy, as already proven by a large number of studies in the last decades. Our data indicate that better results were obtained with non-lesional focal epilepsy patients, although other groups still showed significant improvements. Limited access to stereo-EEG in resource-limited countries may be bypassed with VNS implantation, with worthwhile palliative results.
Funding: Please list any funding that was received in support of this abstract.: This study was conducted with no external funding.
Surgery