Efficacy and safety of vagal nerve stimulation in patients with pharmacoresistant epilepsy

Abstract

Stimulation of the vagal nerve is an effective treatment option in patients with pharmacoresistant epilepsy. Objective: to analyze the efficacy and safety of the Vagal Nerve Stimulation (VNS) procedure in patients suffering from pharmacoresistant epilepsy. Materials and Methods: The study included 13 patients with pharmacoresistant epilepsy, aged 5 to 38 years. Results: among these patients, 25% reported a decrease in the number of epileptic seizures within one-month time after the first session of VNS. The efficacy of the treatment improved with a prolonged use of the VNS-therapy. Despite the long duration of the current pharmacoresistant form of epilepsy in most patients, a decrease in the severity of epileptic seizures and post-seizure disorientation was noted. Side effects of VNS-therapy were recorded in 38.5% of patients; in those, a correction of VNS parameters was performed. This approach allowed us to maintain the effective VNS-therapy and correct the arising side effects. Conclusion: vagal stimulation is an effective non-pharmacological option in patients with pharmacoresistant therapy who have contraindications for surgical treatment. The VNS-therapy reduces the occurrence rate of epileptic seizures by >50% in 20-50% of patients. The VNS therapy has a good long-term efficacy in patients of any age. Stimulation of the vagal nerve is usually well tolerated.