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Vagus nerve stimulation in the treatment of drug-resistant epilepsy in 29 children

Abstract : Background/purpose: Vagus nerve stimulation (VNS) has been demonstrated to be safe and effective for adults and children with drug-resistant epilepsy and is able to improve most types of epilepsy. The aim of this study, in a paediatric population, was to assess the overall efficacy of vagus nerve stimulation on seizures, to assess tolerability and quality of life. Methods: This single-centre, retrospective study reviewed the files of 29 children in whom a vagus nerve stimulator was implanted between 1995 and 2012. The response rate (greater than 50% reduction of the seizure frequency), antiepileptic efficacy according to the type of epilepsy or age at implantation or age at onset of epilepsy, the time-course of seizures, adverse effects, overall quality of life and number of hospitalisations were studied. Results: In our population, vagus nerve stimulation achieved a significant reduction in the seizure frequency throughout follow-up (p = 0.015). Response rates were 59% at 3 months, and 66% at 6 months, and the response rate then remained stable at about 70%. Stimulation tended to be more effective in patients with non-idiopathic partial epilepsy than in patients with non-idiopathic and idiopathic generalised epilepsy (0.01 < p < 0.11). No other predictive factors of efficacy were identified. Patients, parents, caregivers reported improvement in overall quality of life in 38% of patients during clinical interviews. A significant reduction in the number of hospitalisations due to a reduction of seizure frequency was observed after implantation (p = 0.03). VNS was stopped because of complications or insufficient efficacy in 9 cases. Conclusion: Vagus nerve stimulation is a safe and effective treatment option in children with drug-resistant epilepsy who are not candidates for surgery. (C) 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03603522
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Soumis le : mercredi 9 mars 2022 - 21:10:27
Dernière modification le : vendredi 25 mars 2022 - 18:12:15

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Emilie Bodin, Anne-Gaelle Le Moing, Emilie Bourel-Ponchel, Laurent Querne, Patrick Toussaint, et al.. Vagus nerve stimulation in the treatment of drug-resistant epilepsy in 29 children. European Journal of Paediatric Neurology, 2016, 20 (3), pp.346-351. ⟨10.1016/j.ejpn.2016.01.011⟩. ⟨hal-03603522⟩

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