Authors :
Presenting Author: Hideaki Shiraishi, MD, PhD – Hokkaido Univarsity Hospital, Epilepsy Center
Kiyoshi Egawa, MD, PhD – Hokkaido University Hospital; Midori Nakajima, MD, PhD – Hokkaido University Hospital; Kaoru Murakami, DMD – Institute for Genetic Medicine, Hokkaido University; Yuki Ueda, MD, PhD – Hokkaido University Hospital; Sachiko Nakakobo, MD – Hokkaido University Hospital; Masashi Narugami, MD – Hokkaido University Hospital; Shuhei Kimura, MD – Hokkaido University Hospital; Takeru Goto, MD – Hokkaido University Hospital; Yasuyoshi Hiramatsu, MD – Hokkaido University Hospital; masaaki Murakami, DVM – Institute for Genetic Medicine, Hokkaido University
Rationale: Transcutaneous auricular vagus nerve stimulation (taVNS) was performed in two patients suffering structural focal epilepsy with preserved intellectual ability to show the feasible efficacy of taVNS for designated patient groups.
Methods: Patient 1 was a 24-year-old female with frontal lobe epilepsy
who had weekly hyperkinetic seizures even with the following anti-seizure medication: carbamazepine (CBZ), lamotrigine, perampanel, zonisamide, and lacosamide. Patient 2 was a 27-year-old female patient with parietal lobe epilepsy and focal cortical dysplasia in the vicinity of a paramedian lipoma. She experiences weekly focal-impaired awareness seizures even with anti-seizure medication: CBZ and levetiracetam. taVNS was applied to the left earlobe at 1.5 mA, 25 Hz, 250 μsec pulse width, and 30-sec stimulation with 30 seconds rest for four hours per day. Based on an eight-week baseline and 20 weeks of stimulation, the rate of reduction in seizure frequency and quality of life (QOL) were evaluated using the Short-Form 36-Item Health Survey (SF-36).
Results: At baseline, we measured up to eleven focal seizures per week in patient 1 and twelve focal seizures in Patient 2. Both patients achieved seizure freedom at fourth and 20th week, respectively. QOL ratings increased in both patients, and no significant adverse events occurred during the study period.
During the maintenance period after 20 weeks, seizure waves remained resolved in case 1, and seizures remained reduced in case 2.
Conclusions: taVNS might therefore play some role in controlling seizures in patients with structural focal epilepsy and preserved cognitive function.
Funding: This work was supported by KAKENHI, Q-Leap (JPMXS0120330644), and AMED including
JP21zf0127004. This study was also supported partly by the Grant for Joint Research Program of the Institute for Genetic Medicine, Hokkaido University, by the Photo-excitonic Project, Hokkaido University
, and by the Promotion Project for Young Investigators at Hokkaido University.