Vagal nerve stimulation for drug-resistant epilepsy: Adverse events and outcome in a series of patients with long-term follow-up

R. Morace, G. Di Gennaro, P. P. Quarato, A. D’Aniello, A. Mascia, L. Grammaldo, M. de Risi, A. Sparano, F. di Cola, M. de Angelis, V. Esposito

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Citation (Scopus)

Abstract

Background: Vagal nerve stimulation (VNS) is a palliative treatment option for drug-resistant epilepsy. The aim of this study was to describe the clinical and demographic features of selected patients scheduled for VNS and to evaluate the long-term efficacy of VNS in seizure control. Materials and Methods: Between 2006 and 2013, 32 consecutive epileptic patients (14 male and 18 female) were enrolled at our Institute for VNS implantation. In all cases resective surgery had previously been excluded by the use of a noninvasive presurgical study protocol. Mean age was 32 years (range 18–50), and mean epilepsy duration 23 years (range 11–39). All subjects were followed-up for at least 2 years (mean 6 years, range 2–9) after VNS implantation. Patients were considered responders when a reduction of seizures of more than 50 % was reported. Results: All patients had complex partial seizures, in 81 % of the patients with secondary generalization and in 56 % with drop attacks. Neurological examination revealed focal deficits in 19 % of the patients. Brain magnetic resonance imaging (MRI) was positive in 47 % of the patients. No surgical complications were observed in this series. Three patients were lost to follow-up. Twelve patients were classified as responders. Among the others, 1 patient experienced side effects (snoring and groaning during sleep) and the device was removed. Conclusions: Our data confirm that VNS is a safe procedure and a valid palliative treatment option for drug-resistant epileptic patients not suitable for resective surgery.

Original languageEnglish
Title of host publicationActa Neurochirurgica, Supplementum
PublisherSpringer-Verlag Wien
Pages49-52
Number of pages4
Volume124
DOIs
Publication statusPublished - Jan 1 2017

Publication series

NameActa Neurochirurgica, Supplementum
Volume124
ISSN (Print)0065-1419
ISSN (Electronic)2197-8395

Fingerprint

Vagus Nerve Stimulation
Seizures
Palliative Care
Drug Resistant Epilepsy
Snoring
Lost to Follow-Up
Neurologic Examination
Syncope
Epilepsy
Sleep

Keywords

  • Drug-resistant epilepsy
  • Intractable epilepsy
  • Neuromodulation
  • Palliative surgery
  • Vagal nerve stimulation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Vagal nerve stimulation for drug-resistant epilepsy : Adverse events and outcome in a series of patients with long-term follow-up. / Morace, R.; Di Gennaro, G.; Quarato, P. P.; D’Aniello, A.; Mascia, A.; Grammaldo, L.; de Risi, M.; Sparano, A.; di Cola, F.; de Angelis, M.; Esposito, V.

Acta Neurochirurgica, Supplementum. Vol. 124 Springer-Verlag Wien, 2017. p. 49-52 (Acta Neurochirurgica, Supplementum; Vol. 124).

Research output: Chapter in Book/Report/Conference proceedingChapter

Morace, R, Di Gennaro, G, Quarato, PP, D’Aniello, A, Mascia, A, Grammaldo, L, de Risi, M, Sparano, A, di Cola, F, de Angelis, M & Esposito, V 2017, Vagal nerve stimulation for drug-resistant epilepsy: Adverse events and outcome in a series of patients with long-term follow-up. in Acta Neurochirurgica, Supplementum. vol. 124, Acta Neurochirurgica, Supplementum, vol. 124, Springer-Verlag Wien, pp. 49-52. https://doi.org/10.1007/978-3-319-39546-3_8
Morace, R. ; Di Gennaro, G. ; Quarato, P. P. ; D’Aniello, A. ; Mascia, A. ; Grammaldo, L. ; de Risi, M. ; Sparano, A. ; di Cola, F. ; de Angelis, M. ; Esposito, V. / Vagal nerve stimulation for drug-resistant epilepsy : Adverse events and outcome in a series of patients with long-term follow-up. Acta Neurochirurgica, Supplementum. Vol. 124 Springer-Verlag Wien, 2017. pp. 49-52 (Acta Neurochirurgica, Supplementum).
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T2 - Adverse events and outcome in a series of patients with long-term follow-up

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AU - Di Gennaro, G.

AU - Quarato, P. P.

AU - D’Aniello, A.

AU - Mascia, A.

AU - Grammaldo, L.

AU - de Risi, M.

AU - Sparano, A.

AU - di Cola, F.

AU - de Angelis, M.

AU - Esposito, V.

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N2 - Background: Vagal nerve stimulation (VNS) is a palliative treatment option for drug-resistant epilepsy. The aim of this study was to describe the clinical and demographic features of selected patients scheduled for VNS and to evaluate the long-term efficacy of VNS in seizure control. Materials and Methods: Between 2006 and 2013, 32 consecutive epileptic patients (14 male and 18 female) were enrolled at our Institute for VNS implantation. In all cases resective surgery had previously been excluded by the use of a noninvasive presurgical study protocol. Mean age was 32 years (range 18–50), and mean epilepsy duration 23 years (range 11–39). All subjects were followed-up for at least 2 years (mean 6 years, range 2–9) after VNS implantation. Patients were considered responders when a reduction of seizures of more than 50 % was reported. Results: All patients had complex partial seizures, in 81 % of the patients with secondary generalization and in 56 % with drop attacks. Neurological examination revealed focal deficits in 19 % of the patients. Brain magnetic resonance imaging (MRI) was positive in 47 % of the patients. No surgical complications were observed in this series. Three patients were lost to follow-up. Twelve patients were classified as responders. Among the others, 1 patient experienced side effects (snoring and groaning during sleep) and the device was removed. Conclusions: Our data confirm that VNS is a safe procedure and a valid palliative treatment option for drug-resistant epileptic patients not suitable for resective surgery.

AB - Background: Vagal nerve stimulation (VNS) is a palliative treatment option for drug-resistant epilepsy. The aim of this study was to describe the clinical and demographic features of selected patients scheduled for VNS and to evaluate the long-term efficacy of VNS in seizure control. Materials and Methods: Between 2006 and 2013, 32 consecutive epileptic patients (14 male and 18 female) were enrolled at our Institute for VNS implantation. In all cases resective surgery had previously been excluded by the use of a noninvasive presurgical study protocol. Mean age was 32 years (range 18–50), and mean epilepsy duration 23 years (range 11–39). All subjects were followed-up for at least 2 years (mean 6 years, range 2–9) after VNS implantation. Patients were considered responders when a reduction of seizures of more than 50 % was reported. Results: All patients had complex partial seizures, in 81 % of the patients with secondary generalization and in 56 % with drop attacks. Neurological examination revealed focal deficits in 19 % of the patients. Brain magnetic resonance imaging (MRI) was positive in 47 % of the patients. No surgical complications were observed in this series. Three patients were lost to follow-up. Twelve patients were classified as responders. Among the others, 1 patient experienced side effects (snoring and groaning during sleep) and the device was removed. Conclusions: Our data confirm that VNS is a safe procedure and a valid palliative treatment option for drug-resistant epileptic patients not suitable for resective surgery.

KW - Drug-resistant epilepsy

KW - Intractable epilepsy

KW - Neuromodulation

KW - Palliative surgery

KW - Vagal nerve stimulation

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