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Child's Nervous System

, Volume 33, Issue 1, pp 145–151 | Cite as

An interictal EEG can predict the outcome of vagus nerve stimulation therapy for children with intractable epilepsy

  • Min-Jee Kim
  • Mi-Sun Yum
  • Eun-Hee Kim
  • Yun-Jeong Lee
  • Junkyo Lee
  • Seokho Hong
  • Su Jeong YouEmail author
  • Yong soon Hwang
  • Tae-Sung KoEmail author
Original Paper

Abstract

Purpose

This study aimed to evaluate the long-term efficacy of vagus nerve stimulation (VNS) in children and adolescents with intractable epilepsy and identify predictive factors for responsiveness to VNS.

Methods

Medical records of pediatric patients who underwent VNS implantation at two Korean tertiary centers were reviewed. At 0.5, 1, 3, and 5 years post-VNS implantation, the frequency of the most disabling seizures in each patient was assessed. Responders were defined as showing an overall 50 % reduction from baseline seizure frequency during follow-up. The clinical characteristics of responders and non-responders were compared.

Results

Among 58 patients, approximately half (29/58) were responders. The mean age at implantation was 10.9 years (range, 2.7–20.9) and the mean follow-up duration after VNS implantation was 8.4 years (range, 1–15.5). At 0.5, 1, 3, and 5 years after implantation, 43.1, 50.0, 56.9, and 58.1 % of patients exhibited ≥50 % seizure frequency reduction disabling seizures. The patients with focal or multifocal epileptiform discharges were more likely to be responders than those with generalized epileptiform activities by video or conventional EEG at the time of VNS implantation (Pearson’s and χ 2 test, p = 0.001). No other clinical variables were found to be associated with seizure outcomes. Wound infections caused VNS removal in two cases. All other adverse events, including cough and hoarseness, were tolerable.

Conclusion

VNS is a well-tolerated and effective adjuvant therapy in pediatric patients with intractable epilepsy. Notably, patients with focal epileptiform discharges alone rather than those with generalized epileptiform discharges maybe better candidates for VNS.

Keywords

Vagus nerve stimulation (VNS) Pediatric Child Epilepsy EEG 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest statement.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Min-Jee Kim
    • 1
  • Mi-Sun Yum
    • 1
  • Eun-Hee Kim
    • 2
  • Yun-Jeong Lee
    • 1
  • Junkyo Lee
    • 3
  • Seokho Hong
    • 3
  • Su Jeong You
    • 4
    Email author
  • Yong soon Hwang
    • 5
  • Tae-Sung Ko
    • 1
    Email author
  1. 1.Department of Pediatrics, Asan Medical Center Children’s HospitalUlsan University College of MedicineSeoulSouth Korea
  2. 2.Department of Pediatrics, CHA Gangnam Medical CenterCHA UniversityPocheon-siSouth Korea
  3. 3.Department of Neurosurgery, Asan Medical Center Children’s HospitalUlsan University College of MedicineSeoulSouth Korea
  4. 4.Department of Pediatrics, Sanggye Paik HospitalInje University College of MedicineSeoulSouth Korea
  5. 5.Department of Neurosurgery, Sanggye Paik HospitalInje University College of MedicineSeoulSouth Korea

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