TY - JOUR
T1 - Vagus nerve stimulation as a treatment for refractory epilepsy
T2 - A 15-year experience in an Italian Tertiary - Care epilepsy center
AU - Pizzanelli, Chiara
AU - Galli, Renato
AU - Giorgi, Filippo S.
AU - Iudice, Alfonso
AU - Bonanni, Enrica
AU - Pelliccia, Veronica
AU - Jensen, Stella
AU - Manca, Laura
AU - Lenzi, Bruno
AU - Lutzemberger, Ludovico
AU - Parenti, Giuliano
AU - Fornai, Francesco
AU - Murri, Luigi
PY - 2011/5
Y1 - 2011/5
N2 - Purpose: Vagus Nerve Stimulation (VNS) is indicated in the treatment of pharmacoresistant epilepsy. Albeit its general efficacy, the use of VNS remains undefined concerning two points: i) there are only a few long-term studies, none randomized; ii) there are no clinical markers which allow to predict VNS response. In order to explore these points, we report the long-term outcomes of VNS in 22 patients. Methods: Twenty-two patients with refractory epilepsy, either symptomatic generalized or cryptogenic/symptomatic partial were treated with VNS and monitored up to 15 years (6.5±1.1). Results: No significant adverse events were observed. VNS efficacy was enduring and increased significantly over time. Seizure frequency decreased by 34.3±3.9% after 1 year, 40.3±4.6% after 2 years, 48.0±5.4% after 3 years, 53.4±7.9% after 5 years and 48.1%±5.8 at maximum follow up. Data on syndrome-specificity were not significant (small number of patients in each group). Conclusions: This study confirms sustained efficacy of VNS in epilepsy. Generalized symptomatic and temporal lobe epilepsy seem to be associated to a better outcome to VNS, but additional data are required.
AB - Purpose: Vagus Nerve Stimulation (VNS) is indicated in the treatment of pharmacoresistant epilepsy. Albeit its general efficacy, the use of VNS remains undefined concerning two points: i) there are only a few long-term studies, none randomized; ii) there are no clinical markers which allow to predict VNS response. In order to explore these points, we report the long-term outcomes of VNS in 22 patients. Methods: Twenty-two patients with refractory epilepsy, either symptomatic generalized or cryptogenic/symptomatic partial were treated with VNS and monitored up to 15 years (6.5±1.1). Results: No significant adverse events were observed. VNS efficacy was enduring and increased significantly over time. Seizure frequency decreased by 34.3±3.9% after 1 year, 40.3±4.6% after 2 years, 48.0±5.4% after 3 years, 53.4±7.9% after 5 years and 48.1%±5.8 at maximum follow up. Data on syndrome-specificity were not significant (small number of patients in each group). Conclusions: This study confirms sustained efficacy of VNS in epilepsy. Generalized symptomatic and temporal lobe epilepsy seem to be associated to a better outcome to VNS, but additional data are required.
KW - Alternative therapy
KW - Epilepsy
KW - Long-term study
KW - Neurosurgery
KW - Pharmacoresistance
KW - Vagus nerve stimulation
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M3 - Article
AN - SCOPUS:79955948523
VL - 8
SP - 321
EP - 329
JO - Letters in Drug Design and Discovery
JF - Letters in Drug Design and Discovery
SN - 1570-1808
IS - 4
ER -