Abstracts

Rationale: Vagus nerve stimulation (VNS) has been established as a safe and effective therapy for adults and children 14 and over with medically refractory localization-related epilepsy (MRE). An addition to the therapy became available in the Spring of 2015 with the  VNS AspireSR which provides automatic stimulation to terminate seizures in response to changes in heart rate associated with seizures. The purpose of this study was to collect demographical information on patients utilizing the VNS AspireSR since availability, and whether a broader utilization of the device was utilized than the FDA guidelines. This study was designed to broad demographic information for an ongoing prospective study on the effective of the Aspire therapy in clinical practice.  Methods: From our large, multi-site regional epilepsy program, 23 patients had received VNS AspireSR implants within the past two years and their demographic data was collected for this study. The data will be included in a larger study on the effectiveness of the therapy. Of the 23 patients, 15 (65%) were male and 8 (35%) were female.  Results:  The median age at implantation was 14 years (range 7–43 years). At the time of VNS implant, 3 patients (13%) were 10 years old or younger, 9 patients (39%) were between the age of 11 and 20, 3 patients (13%) were between the age of 21 and 30, 3 patients (13%) were between the age of 31 and 40 years old, 2 patients (9%) were between the age 41 and 50, 1 patient (4%) was between the age of 51 and 60, and 2 patients (9%) were between the age of 61 and 70. Of the patients receiving VNS AspireSR implants, 9 patients (39%)  had generalized epilepsy, 13 patients (56 %), and 1 was unclear. The mean age at epilepsy onset was 1 years (range 0-7 years). The mean duration of epilepsy before VNS therapy was 24 years (range 4-63 years). 3 patients (13%) had undergone surgery in addition to VNS treatment, however the mean age of surgery patients was 44 years old. The average number of previously used AEDs was 6 for this cohort (range 3-15).2 Patients (8.7%) had used medical marijuana. Conclusions: The majority of patients using he VNS AspireSR  therapy were young , < 20 years of age and had focal epilepsy.  Compared to previously published reports1 of the use of VNS therapy in a large practice,  there were less previous surgery patients, a younger cohort, and a larger percentage with generalized epilespy.  Further analysis with be interesting to determine if this cohort with the newer technique will have a difference in  outcome than previoulsy reported outcomes. 1.Elliot, RE, et al Epilepsy Behav. 2011 Jan;20(1):57-63. Funding: None