Vagal Nerve Stimulation has Robust Effects on Neuropsychiatric Assessment in Resistant Epilepsy: A Clinical Series with Clinical Experiences.

Abstract

To evaluate the resistant epileptic patients who had vagal nerve stimulation (VNS) devices implanted over five years, and to evaluate the neuropsychological aspects of VNS. Patients with pharmacoresistant epilepsy (PRE) were followed from 2012 to 2017. Totally seven patients were found eligible for VNS in this period. In the pre-surgical period, patients were neuro-psychiatrically assessed by an independent psychiatric committee for mental status, which included assessment of intelligence quotient (IQ), Wechsler adult intelligence scale-revised (WAIS-R) IQ, Stroop test and mini-mental state examination (MMSE), Hamilton depression scale (HDS) and the Beck anxiety inventory (BAI). The positive effects of VNS on patients' well-being and neuropsychiatric status may be the most as important as the treatment's cost effectiveness. The patients' quality of life (QoL) was calculated just before and 12th / 24th months after VNS implantation. The pre-VNS scores for Quality of Life in Epilepsy (QoLiE-31-P) ranged from 14-59, and average score was 37.14.The post-VNS scores ranged from 31-72, and the average score was 52.86. VNS has intense effects on QoL of epileptic patients. The best approach for comparing and evaluating QoL in PRE patients may be the QoLiE-31-P inventory, which can be adapted and used in epilepsy centers to evaluate energy, mood, daily activity, cognition, medication effects, seizure worry and overall QoL.