Journal of Neurological Sciences (Turkish) Ahead Of Print
VAGUS NERVE STIMULATION IN ADULTS WITH DRUG RESISTANT EPILEPSY: EFFICACY, SIDE EFFECTS AND OUTCOME
hava ozlem dede1, Nerses Bebek1, Betül Baykan1, Ayşen Gökyiğit1, Candan Gürses1
1Istanbul University Istanbul Faculty of Medicine, neurology, Istanbul,
DOI : 10.24165/jns.10193.17 Background: Vagus nerve stimulation (VNS) is an adjunctive therapy for patients with drug-resistant epilepsy (DRE) excluded from ablative surgery or who have had such surgery with no optimal outcome. In this study, we provide an analysis of efficacy, side effects and seizure outcomes after VNS implantation for patients with DRE. Method: We retrospectively examined 17 adult cases (M/F: 12/5) with DRE that received VNS treatment in our center from 2001 to May 2014 and analyzed the following parameters: age of patient receiving VNS, seizure frequency before and after VNS as well as treatment duration and etiological parameters of epilepsy. Results: The well response rate was 58.8% (10/17). The mean age at the time of receiving VNS was 17.4 years, seizure frequency before and after VNS were 28.5/16.4. Epilepsy was caused by a structural or metabolic disorder of the brain: neoplasm, infarct, trauma, mesial temporal sclerosis and encephalitis, in eleven patients (64.7%). The well response rate was (7/11) 63.6% in this group. The well response rate was 50% (3/6) in the genetic or unknown etiology group. The EEG lateralization has the best predictive value for efficacy (p:0.007). In 2 patients with focal motor seizures, 75% and 86.6% seizure reductions were achieved whereas the percentage was 66.7% in the patient with startle epilepsy. Conclusions: VNS is a safe and effective adjunctive treatment for DRE, the best results observed in patient with focal motor and startle epilepsy. Patients with bilateral epileptiform abnormality were seen to have better prognosis with VNS. Keywords : VNS, DRE, vagal nerve stimulation