Abstract
BackgroundVagus nerve stimulation (VNS) has been demonstrated to be safe and effective for patients with refractory epilepsy, but there are few reports on the use of VNS for postencephalitic epilepsy (PEE). This retrospective study aimed to evaluate the efficacy of VNS for refractory PEE.MethodsWe retrospectively studied 20 patients with refractory PEE who underwent VNS between August 2017 and October 2019 in Chinese PLA General Hospital and Beijing Children’s Hospital. VNS efficacy was evaluated based on seizure reduction, effective rate (percentage of cases with seizure reduction ≥ 50%), McHugh classification, modified Early Childhood Epilepsy Severity Scale (E-Chess) score, and Grand Total EEG (GTE) score. The follow-up time points were 3, 6, and 12 months after VNS. Pre- and postoperative data were compared and analyzed.ResultsThe median [interquartile range (IQR)] seizure reduction rates at 3, 6, and 12 months after VNS were 23.72% (0, 55%), 46.61% (0, 79.04%), and 67.99% (0, 93.78%), respectively. The effective rates were 30% at 3 months, 45% at 6 months, and 70% at 12 months. E-chess scores before the operation and at 3, 6, and 12 months after the operation were 10 (10, 10.75), 9 (9, 10), 9 (9, 9.75), and 9 (8.25, 9) (P < 0.05), respectively. GTE scores before surgery and at 12 months after the operation were 11 (9, 13) and 9 (7, 11) (P < 0.05), respectively. The mean intensity of VNS current was 1.76 ± 0.39 (range: 1.0–2.5) mA. No intraoperative complications or severe post-operative adverse effects were reported.ConclusionsOur study shows that VNS can reduce the frequency and severity of seizure in patients with refractory PEE. VNS has a good application prospect in patients with refractory PEE.
Highlights
Encephalitis in early childhood may damage brain tissue and it may cause neurological sequelae, including epilepsy.Epidemiological studies reported a 16.4–29% incidence of epilepsy secondary to encephalitis, among which refractory epilepsy accounts for 7–15% (Lee et al, 2007; Sellner and Trinka, 2012; Singh et al, 2015; Pillai et al, 2016)
Postencephalitic epilepsy is a common sequela of acute encephalitis, which is defined as unprovoked seizure occurring after the acute phase of encephalitis
4.83 years, after the diagnosis of encephalitis. When they were diagnosed with epilepsy, we carried out comprehensive examinations of the patients, excluding the causes of infection, immunity, metabolism, and heredity
Summary
Encephalitis in early childhood may damage brain tissue and it may cause neurological sequelae, including epilepsy.Epidemiological studies reported a 16.4–29% incidence of epilepsy secondary to encephalitis, among which refractory epilepsy accounts for 7–15% (Lee et al, 2007; Sellner and Trinka, 2012; Singh et al, 2015; Pillai et al, 2016). The severity and refractory nature of PEE necessitate the identification of alternative treatment options Since it was first proposed in 1988, vagus nerve stimulation (VNS) has been recognized worldwide as an approved and effective adjunctive therapy for medically intractable epilepsy (Hajnsek et al, 2005; González et al, 2019). Vagus nerve stimulation (VNS) has been demonstrated to be safe and effective for patients with refractory epilepsy, but there are few reports on the use of VNS for postencephalitic epilepsy (PEE). This retrospective study aimed to evaluate the efficacy of VNS for refractory PEE
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
