Abstract
Purpose
To analyze the indication, complications and outcome of vagus nerve stimulation in intractable childhood epilepsy.
Materials and methods
We retrospectively reviewed the data of 69 children who had insertion of vagal nerve stimulator (VNS) between June 1995 and August 2006 for medically intractable epilepsy. Outcome was based on the Engel's classification. Statistical analysis of the data was also done to see if any of the parameters significantly influenced the outcome.
Result
Thirty-eight patients (55.08 %) had a satisfactory outcome (Engel class I, II or III), and in 31 patients (44.92 %), there was no worthwhile improvement of seizures (Engel class IV). There was no statistical significance between the type of seizure and outcome (Fisher's exact test, p = 0.351). Statistical analysis also showed that the following parameters did not significantly influence the outcome (p > 0.05): age at insertion of VNS, age of first fit, duration between first fit and insertion of VNS and the length of follow-up. Complications included infection, lead fracture, fluid collection around the stimulator, neck pain and difficulty swallowing.
Conclusion
Vagus nerve stimulation is a relatively safe and potentially effective treatment for children with medically intractable epilepsy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Schachter SC, Saper CB (1998) Vagus nerve stimulation. Epilepsia 39(7):677–686
Majoie HJM, Berfelo MW, Aldenkamp AP, Renier WO, Kessels AGH (2005) Vagus nerve stimulation in patients with catastrophic childhood epilepsy, a 2 year follow up study. Seizure 14:10–18
Ben-Menachem E, Mañon-Espaillat R, Ristanovic R, Wilder BJ, Stefan H, Mirza W, Tarver WB, Wernicke JF (1994) Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. Epilepsia 35:616–626
Ramsay RE, Uthman BM, Augustinsson LE, Upton AR, Naritoku D, Willis J, Treig T, Barolat G, Wernicke JF (1994) Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. Epilepsia 35:625–634
Murphy JV, Homig G, Schallert G (1995) Left vagal nerve stimulation in children with refractory epilepsy. Arch Neurol 52:886–889
Hornig GW, Murphy JV, Schallert G, Tilton C (1997) Left vagus nerve stimulation in children with refractory epilepsy: an update. South Med J 90(5):484–488
Parker AP, Polkey CE, Binnie CD, Madigan C, Ferrie CD, Robinson RO (1999) Vagal nerve stimulation in epileptic encephalopathies. Pediatrics 103(4 Pt 1):778–782
Nagarajan L, Walsh P, Gregory P, Lee M (2002) VNS therapy in clinical practice in children with refractory epilepsy. Acta Neurol Scand 105(1):13–17
Kemeny AA (2003) Surgical technique in vagus nerve stimulation. In: Schachter SC, Schmidt D (eds) Vagus nerve stimulation, 2nd edn. Martin Dunitz, London, pp 11–24
Engel J Jr, Van Ness PC, Rasmussen TB (1993) Outcome with respect to epileptic seizures. In: Engel J Jr (ed) Surgical treatment of the epilepsies, 2nd edn. Raven, New York, pp 609–621
Patwardhan RV, Stong B, Bebin EM, Mathisen J, Grabb PA (2000) Efficacy of vagal nerve stimulation in children with medically refractory epilepsy. Neurosurgery 47:1353–1357 discussion 1357–1358
Blount JP, Tubbs RS, Kankirawatana P, Kiel S, Knowlton R, Grabb PA, Bebin M (2006) Vagus nerve stimulation in children less than 5 years old. Childs Nerv Syst 22:1167–1169
Rychlicki F, Zamponi N, Cesaroni E, Corpaci L, Trignani R, Ducati A, Scerrati M (2006) Complications of vagal nerve stimulation for epilepsy in children. Neurosurg Rev 29(2):103–107
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kabir, S.M.R., Rajaraman, C., Rittey, C. et al. Vagus nerve stimulation in children with intractable epilepsy: indications, complications and outcome. Childs Nerv Syst 25, 1097–1100 (2009). https://doi.org/10.1007/s00381-009-0849-z
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-009-0849-z