Abstracts

Vagus nerve stimulation (VNS) with the neuro cybernetic prothesis (NCP) is an approved treatment for epilepsy. It is indicated for use as an adjunctive therapy in reducing the frequency of seizures in adults and adolescents over twelve years of age with seizures refractory to antiepileptic medications. Clinical experience of developmentally disabled or mentally retarded patients with epilepsy indicates they benefit from VNS, however understanding their unique experience challenges traditional methods of evaluation. Supervised community residential staff and/or family members are uniquely involved with this category of patients, providing pre and post implant evaluations of patient status. The purpose of this study was to gain a better understanding of VNS, as a treatment in a developmentally disabled population who were living at home or in a supervised residential community setting. A retrospective chart review was conducted on (N = 48) patients with an NCP implanted. There were 39% (19/48) with a diagnosis of developmental disability. Data were reviewed for age, gender, seizure classification, seizure frequency, VNS settings, side effects of VNS, duration of VNS therapy, antiepileptic medications, magnet use, and reports from family or supervised community residential care-givers. A total of (N = 19) patients were entered into the analysis. Age range was (3 to 54 years). and gender (M = 17 and F = 3). The majority had generalized seizures or complex partial with secondary generalization. Duration of VNS treatment ranged from 6 months to over 5 years. Lennox Gastaut was diagnosed in (N = 4). There were (N = 9) living at home with their families and (N = 10) living in a supervised group residential setting. One died due to complications not related to VNS, after one year of treatment. Only (N = 6) were capable of understanding the indications for VNS implantation and treatment effects. Only (N=5) were capable of learning magnet self-use. The majority received magnet assistance from residential staff and family members. Staff of community group homes received inservice training on VNS treatment and offered suggestions for long-term monitoring of their residential clients. Staff followed a variety of residential VNS protocols designed for seizure recording and magnet use in their clients. VNS appears well tolerated in this small group of developmentally disabled patients. Family and care-givers are significant to patient adjustment to living with VNS and their long-term treatment follow-up. VNS may be an important treatment consideration for this population of refractory patients.