Last modified: 2018-09-09
Abstract
introduction:
We undertook this study to analyse our centre experience regarding the efficacy of [VNS] therapy as additional-method in the management of children under 18years with resistant epilepsy.
Methods:
Retrospective-observational study at a university teaching hospital paediatric epilepsy clinic. Reviewed clinical notes of children with drug-resistant epilepsy who were treated with VNS-therapy.
We found fourteen children were actively-programmed with VNS along with anti-epileptic medications.
Results:
The mean age at time of first VNS insertion was 7years(2-10 years) and mean duration of VNS therapy 5.35years(1–10 years).
Aetiology of epilepsy is known in three children[3/14(21.4%)] with genetic-causes and four[4/14(28.5%)] has structural lesions.
Co-morbidities: All the patients had learning-difficulty, one had ASD(7.1%) and one ADHD(7.1%).
Eight children were on two-AEDs[8/14(57.2%)], six(42.8%) were on three AEDs and one on ketogenic-diet(Plus two AEDs).Various VNS models of programmable device used currently in our cohort including eight children[8/14(57.1%)] has Aspire-SR 106 and two[2/14 (14.2%)] has Aspire105.
In pre-VNS implantation: Eleven children(78.5%) had multiple-daily seizures and 3(21.4%) had seizures once in 2-3weeks.
Post-VNS implantation:7[7/14(50%)] reported no change in the seizure frequency and severity however three of them(21.4%) had improvement in mood and behaviour and seven(50%) had noticeable improvement in form of shorter seizures and quicker recovery post-seizure.
Two[2/14(14.2%)] developed complication post-VNS implantation, one(7.1%) unilateral vocal-cord palsy and other(7.1%) neck swelling.
Conclusion:
VNS therapy as an add-on therapy for drug-resistant epilepsy led to varying degree of improvement in the frequency and severity of seizures along with perceptible improvement in mood and behaviour.
Two patients showed side-effects were surgery-related.