Vagus nerve stimulation therapy for post-encephalitic intractable epilepsy in children

Abstract

Objective To evaluate the effect of vagus nerve stimulation (VNS) on post-encephalitic intractable epilepsy and the improvement of postoperative cognitive function and quality of life. Methods The patients with post-encephalitic epilepsy in Sanbo Brain Hospital, Capital Medical University from January 2008 to December 2016 were selected.A single center and retrospective study method was used to evaluate the cognitive function, social function of preoperative and postoperative and postoperative seizure classification.The follow-up time points included preoperative, posto-perative in 6 months, 1 year after operation and postoperative annual review. Results A total of 43 patients were followed up, including 19 females and 24 males, with an average age of (9.37± 4.18) years old.The time of follow-up was (43.90 ± 33.04) months.According to Engel classification: Grade Ⅰ 3 cases (7.0%), grade Ⅱ 3 cases (7.0%), grade Ⅲ 14 cases (32.6%), grade Ⅳ 21 cases (48.8%). According to McHugh classification: Grade Ⅰ 8 cases (18.6%), grade Ⅱ 12 cases (28%), grade Ⅲ 11 cases (25.5%), grade Ⅳ 6 cases (14.0%), grade Ⅴ 4 cases (9.3%). Speech improvement of postoperative: significant improvement in 3 cases (7.0%), slightly improved in 17 cases (39.6%); interpersonal communication improvement of postoperative: significantly increased 7 cases (16.4%), slightly improved 16 cases(37.2%); learning/working ability improvement of postoperative: significantly improved 6 cases(14.0%), slightly increased 14 cases(32.6%). The postoperative VIQ (6.21±5.02) scores, PIQ (7.28±6.10) scores, FIQ (2.93±3.74) scores and MQ were (4.81±2.98) scores higher than preoperative. Conclusions VNS can effectively improve the seizures of post-encephalitic epilepsy as well as the children′s quality of life, cognition and social function. Key words: Post-encephalitic epilepsy; Vagus nerve stimulation; Cognitive function; Follow-up study