Abstracts

Vagal Nerve Stimulators (VNS) were approved for treatment of medically and surgically refractory epilepsy in 1977. The precise mechanism of action is unknown, however, neurologist in the 19^th century knew that applying pressure to the carotid artery could abort seizures. The objective of this study is to assess the efficacy of VNS in reducing seizure frequency, decreasing antiepileptic drug (AED) burden, and allowing self-management in patients with intractable epilepsy. A retrospective chart review was conducted on 25 patients with intractable epilepsy, ages 16 to 62, who had VNS implanted as adjunctive therapy within the past 9 years. The mean age of VNS [italic]implantation [/italic]was 34 (ages ranging from 10 to 57 years old). 18 patients had complex partial seizures, 1 had partial seizures, 3 had primary generalized seizures, and 3 had Lennox Gastaut Syndrome. Of the 25 patients, 15 (60%) had a reduction in seizure frequency, and 12 of these patients had [underline][gt][/underline] 50% reduction in seizure frequency. 1 patient had no change in seizure frequency, 1 had an increase in seizure frequency, and 8 patients had insufficient data to accurately assess seizure outcome. 6 (46%) patients had a reduction in the number of AEDs used, 2 had no change, 5 had an increase in the number of AEDs, and 12 patients had insufficient data. Of the 25 patients, 19 used the magnet to abort seizures. 15 (79%) patients stated that the magnet was beneficial in stopping or decreasing length of seizures, 3 attributed no benefit, and 1 patient did not indicate. Complications or side effects were experienced by 13 patients, which included breathing difficulty, dysphagia, hoarseness, referred pain, weight loss, gastroparesis, agitation, and infected wounds. 4 patients total had the VNS removed without replacement: 2 because of no benefit, 1 because of an infected wound, and 1 for an unknown reason. Vagal Nerve Stimulators are effective when used as adjunctive therapy in patients with intractable epilepsy, by reducing seizure frequency, decreasing AED load, and providing patients with a sense of control in aborting seizures with magnet stimulation.