Abstracts

Rationale: We prospectively evaluated efficacy and safety data of 53 pharmacoresistant epilepsy patients treated with VNS Therapy at the Hospital La Princesa in Madrid, Spain. Methods: Five generators were explanted (lack of efficacy, N=3; transient vocal cord paralysis and severe hoarseness, N=1; paranoid state, N=1) and 6 were turned off (lack of efficacy, N=3; severe dyspnea, N=1; vocal cord paralysis, N=1; severe head injury, N=1). For the remaining 42 patients (24M, 18F), mean age was 30.6 ± 9.34 years (median, 28; range, 16 - 58). Mean age at onset of epilepsy was 8.4 ± 6.88 years (median, 6.5 years; range, 3 months – 27 years). Patients had a history of 22.1 ± 7.52 years of epilepsy (median, 22; range, 7 - 44). Sixteen patients (38.1%) had a history of epilepsy surgery. Ten patients (23.8%) had temporal lobe epilepsy. Patients had often multiple types of seizures: complex partial, 85.7%; simple partial, 11.9%; generalized, 57.1%; other, 4.8%. Last follow-up visit: 32.3 ± 18.79 months (median, 27.6; range, 0.7 - 65.1). Results: Mean and median seizure reduction after 6 months: 39.7% and 50.0%, respectively (N=37 patients with enough follow-up data); after 12 months, 37.0% and 50.0%, respectively (N=35); at the last follow-up visit, 48.7% and 71.4%, respectively (N=31); 3/31 patients (9.7%) were seizure-free for 9, 10 and 15 months at the last follow-up visit. Twelve generators were replaced (end-of-service). VNS Therapy was well tolerated. Infection at the incision site occurred in one patient and was successfully treated with antibiotics. Conclusions: VNS Therapy in an effective and safe treatment for patients with a long history of refractory epilepsy.