The effect of vagus nerve stimulator in controlling status epilepticus in children

Abstract

PurposeThis study explores the effect of Vagus Nerve Stimulator (VNS) on Status Epilepticus (SE) in children with medically intractable epilepsy. MethodsRetrospective review was conducted in children with a history of at least two SE, who had VNS implantation and had at least one year follow up after the procedure. ResultsSixteen patients met inclusion/exclusion criteria. The median age of seizure onset and surgery was 1.3 years and 9.0 years, respectively. Prior to VNS implantation, 81% (13/16) of patients had ≥one seizure per month when all seizure types were combined. 75% (12/16) of patients experienced ≥one generalized convulsive seizure per month. The median number of SE prior to VNS was three (2–9), and 63% (10/16) had at least one SE during a year prior to implantation. The proportion of patients who did not have any SE one year after VNS implantation increased compared to the year prior (75% vs. 37%, p = 0.07). The seizure frequency decreased in a minority of patients when all seizure types were combined (20% at one year, p = 1.00, 44% at the last follow up, p = 0.55), but generalized convulsive seizure decreased in 69% of patients at one year (p = 0.01) and 75% of patients at last follow up (p = 0.01). ConclusionVNS appears to have favorable impact on SE and generalized convulsive seizures in children with medically intractable epilepsy.