Abstracts

Rationale: To analyze clinical data and seizure reductions in patients with pharmacoresistant epilepsy associated with hypothalamic hamartomas who were treated with adjunctive Vagus Nerve Stimulation (VNS) Therapy. Methods: Analysis of data from Cyberonics’ International Patient Registry showed 7 patients (6M, 1F) with a mean age of 15.9 years (± 7.03; median 15; range, 6-26). Mean age at onset of epilepsy was 2.8 years (± 3.21; median 1.8; range, 0.1 – 7.8). Gelastic seizures, N=3; partial epilepsy, N=2; generalized, N=1; other, N=1. Mean number of seizures/month over the last 3 months before implantation was 152.9 (range, 4 – 592). Mean follow-up: 39 months (± 16.40; median, 40; range, 23-63). Five patients had behavioral problems, 3 were mentally retarded, 4 had developmental delay, 1 had tuberous sclerosis, 1 had ADHD, 1 had autism and 1 had precocious puberty. MRI results were available for 4 patients and were consistent with the findings expected for hypothalamic hamartomas.Results: There was a median seizure reduction of 35.7%. Seizure reduction >= 50% occurred in 3 patients; one of them showed >=90% seizure reduction. Two patients had <=50% seizure reduction, and 2 patients had an increase in seizures. Mean number of seizures/month at the last follow-up visit was 54.3 (range, 7 – 126). Five patients showed an improvement in alertness. Conclusions: VNS Therapy may be an interesting option for the treatment of patients with pharmacoresistant epilepsy associated with hypothalamic hamartomas. Further investigation of the role of VNS Therapy in this patient population is needed.