Abstracts

Rationale: Epilepsy is a neurological disorder characterized by chronic tendency of recurring, unprovoked seizures. The quality of life could be significantly impaired by epileptic seizures, especially for children under 14 years. The children with epilepsy, whose seizures onset was early and frequency was so high that their development was stagnated, usually defined as “catastrophic childhood epilepsy”. A couple of previous studies showed that the prognosis of children with catastrophic epilepsy depends on the etiology and the early control of the seizures. Surgical treatment has been regarded as most effective way to control the seizures of children with catastrophic epilepsy. Unfortunately, the children with catastrophic epilepsy and surgical contraindication, are defined as treatment-resistant. Under those circumstances, vagus nerve stimulation (VNS) is an optimal approach to achieve the control of seizures of children with treatment-resistant catastrophic epilepsy. Moreover, an increasing body of literature confirmed the efficacy of seizure reduction of VNS in pediatric patients with refractory epilepsy.In addition to the effect on seizure reduction, the efficacy of VNS on neuropsychiatric outcomes, including improvement of quality of life, behavior, cognition, was still a controversial issue. Our purpose was to access the efficacy on seizure reduction, to evaluate the efficacy on neuropsychological outcomes by using Denver Developmental Screening Test (DDST) and Wechsler Intelligence Scale for Children-Chinese (WISC-C). Methods: Our study reviewed files of 56 children treated with vagus nerve stimulation between May, 2008 and December, 2013 in our center. Data was collected from baseline to 12, 24 months of follow-up, including seizure frequency, seizure duration, seizure severity and neuropsychological outcomes. Results:  In the population of these 56 children, vagus nerve stimulation significantly reduced seizure frequency, duration and severity. The response rates (reduction >50%) were 46.4%, 57.2% at 12 months, 24 months. Furthermore, VNS also significantly achieved improvement of neuropsychological outcomes, particularly the language function of the children under 6 years. Conclusions: The children with catastrophic epilepsy, especially those under 6 years, could benefit from vagus nerve stimulation by reducing seizure burden and improving neuropsychological development.  Funding: This study was funded by National Key Technology R&D Program of China (2012BAI03B02), national natural science foundation of China (81571275), BIBD-PXM2013_014226_07_000084, Scientific Research Common Program of Beijing Commission of Education (KM201410025027), Capital Characteristic Clinical Application Research (Z131107002213169), the capital health research and development of special(2016-4-8011)