Abstracts

Epilepsy is very common in tuberous sclerosis complex (TSC) and occurs in 80 to 90% of affected individuals during their lifetime. Although not completely understood, the incidence of epilepsy is thought to relate to the neuropathologic features of the disorder, including cortical tubers and other dysgenetic features., Analysis of data from Cyberonics[apos] International Patient Registry showed 90 patients (53 male, 37 female) with TSC and medically refractory epilepsy who were treated with adjunctive VNS Therapy. Patients had a mean age of 16.7 ([plusmn] 12.00) years. Six (6.7%) patients were institutionalized. Five (5.5%) patients had a prior callosotomy, and 8 (8.9%) patients had a history of lobectomy. Mean follow-up was 32.7 [plusmn] 15.37 months (median: 34.05 months). Epilepsy was localized in 47 (52.2%) cases; 20 patients (22.2%) had generalized seizures, and 14 (15.5%) had Lennox-Gastaut syndrome. Other types of seizures occurred in 22 (24.4%) patients. Data on seizure reductions, magnet use and quality of life (QoL) were collected. , There was a median seizure reduction of 59.4% for the entire patient population at the last follow-up visit (p-value [lt] 0.0001; Wilcoxon[apos]s paired signed rank test). Seizure reductions [ge] 50% occurred in 56.7% of the patients. Magnet use was reported in 67.8% of the cases (N=61). According to 23 patients (25.5%), the magnet was always or most of the time effective in aborting or reducing the intensity and/or duration of their seizures. Another 26.7% of the patients (N=24) reported that the magnet had some effectiveness. More than 50% of the patients reported improvements in alertness and post-ictal state., Adjunctive VNS Therapy was effective for the treatment of medically refractory seizures associated with TSC, with a significant median seizure reduction of 59.4%. Seizure reductions [ge] 50% were reported in 56.7% of the patients. QoL improvements were most pronounced for alertness and post-ictal state.,