Vagus Nerve Stimulator (VNS) Effect On Cases With Bitemporal Drug Resistant Epilepsy
Abstract number :
3.444
Submission category :
9. Surgery / 9C. All Ages
Year :
2022
Submission ID :
2232846
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Ashwaq Alshahrani, MD – Western university hospital; Jorge Burneo, MD – Western university hospital; Jonathan C. Lau, MD – Western university hospital; David Steven, MD – Western university hospital; Ana Suller-Marti, MD – Consultant, Neuroscience, Western university hospital
This is a Late Breaking abstract
Rationale: The most common type of therapy-resistant epilepsy is temporal lobe epilepsy (TLE). Unilateral TLE usually has a favourable prognosis with resective surgery. However, surgery is usually not considered in cases of bilateral temporal lobe epilepsy (biTLE) which occurs in 10% to 20% of patients with TLE. Vagus nerve stimulation (VNS) is approved as a palliative therapeutic option. The outcome of treating bi-TLE with VNS is unknown. Our study evaluates the effect of VNS on the reduction ofseizure frequency in therapy-resistant epilepsy patients with bi-TLE.
Methods::This retrospective study included all patients with bi-TLE who underwent VNS implantation at Western University Hospital from 1997 to 2019. The main outcome was reduction in seizure frequency.
Results: Our study included 17 patients (11 women). The mean seizure onset age was 19.4 years (SD=12.99). Bi-TLE was confirmed by scalp EEG in 8 cases (47%) and invasive recording in 9 (52.9%). The mean follow-up was 48.11 months (SD=59.49). The mean seizure frequency per month before VNS was 8.75/m, and after VNS stimulation was 2.64/m. Compared to the baseline, 11 individuals (64.7%) achieved at least 60% reduction in seizure frequency. None of our patients became seizure free. Six patients (35.3%) experienced either no or minimal reduction in seizure frequency. The responder rate was 87.5% in those who underwent scalp EEG only and 55.5% in those who underwent invasive EEG. Side effects were reported in 10 patients (58.8%). Side effects included mild coughing and hoarseness. In one case, post-surgical wound infection was documented and managed with a brief course of antibiotics.
Conclusions: In therapy-resistant BI-TLE, therapeutic choices are restricted. VNS was shown to be safe and beneficial as an additional treatment in this group of patients.
Funding: None
Surgery