Authors :
Anna Scarabello, MD – University of Bologna. Bologna, Italy
Luca Zanuttini, MD – University of Bologna. Bologna, Italy
Martino Schettino, PhD – IRCCS Istituto delle Scienze Neurologiche di Bologna, UO Epidemiologia e Statistica, Bologna, Italy
Lorenzo Muccioli, MD, PhD – IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE
Lorenzo Ferri, MD, PhD – IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE
Francesca Bisulli, MD – Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
Ilaria Naldi, MD, PhD – AUSL Azienda Unità Sanitaria Locale di Imola
Lilia Volpi, MD – IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE
Roberto Michelucci, MD – IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE
Antonella Boni, MD – IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy
Valentina Gentile, MD – IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy
Mino Zucchelli, MD – IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurochirurgia, Bologna, Italy
Paolo Tinuper, MD – University of Bologna. Bologna, Italy
Matteo Martinoni, MD – IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurochirurgia, Bologna, Italy
Presenting Author: Barbara Mostacci, MD, PhD – IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the ERN EpiCARE
Rationale:
This study investigates the long-term efficacy of vagus nerve stimulation (VNS) therapy, with a specific focus on the most disabling seizure types—tonic-clonic seizures (TCS), drop attacks, and seizure clusters, aiming to identify which seizure types respond most favorably and to refine candidate selection criteria.
Methods:
This retrospective, single-center study included all consecutive adults with DRE who received VNS therapy and had ≥12 months of follow-up. Clinical data were collected at baseline (T0), 12 months post-implantation (T1), and last follow-up (T2). Outcomes included changes in total seizure frequency and severity, frequency of TCS and drop attacks, and frequency and/or duration of seizure clusters. Battery replacement decisions and treatment tolerability were also evaluated.
Results:
The cohort comprised 87 patients (51 males; median age 33 at T0), with a mean follow-up of 8 years at T2. At T2, 54% showed a reduction in total seizure frequency, and 71% reported decreased seizure severity/duration. Among those with TCS at baseline, 80.6% experienced a reduction in frequency, and 24% achieved seizure freedom. Drop attacks improved in 65.4% of cases, with complete resolution in 21.8%. More than 80% of patients with seizure clusters experienced reduced frequency and/or duration. Response rates for these specific seizure types significantly exceeded non-response rates (p < 0.001). Battery replacement was chosen by 85.7% of patients upon or near depletion. Side effects, mostly transient and mild, occurred in 49.4% of cases.