ICNC Abstracts, ICNC 2018

Font Size: 
Efficacy of adjunctive vagus nerve stimulation in patients with Dravet syndrome
Songee Youn

Last modified: 2018-09-09

Abstract


Background: To report the efficacy of vagus nerve stimulation (VNS) for children and adolescents with medically intractable Dravet syndrome (DS).

Methods: Twenty-three patients with SCN1A variants and/or clinical syndromes consistent with DS, underwent VNS therapy at Severance Children’s Hospital between March 2005 and March 2018. Twenty of them, antiepileptic drugs of whose had been unchanged during 6 months after VNS implantation were enrolled. Their medical records contained a minimum of 3 months of data prior to implantation (regarding patient’s seizure types, frequency, and severity). Results: The median age at onset of epilepsy was 6.5 months old (interquartile range 5.25-10.0). In total, 17 (85.0%) patients had pathogenic SCN1A variant. The median age at VNS implantation was 11.1 years old (interquartile range 8.4-13.6). Two (10%) patients reported adverse events, such as hoarseness, deep breathing, coughing, and then had reduction of amplitude of VNS, and the others maintained 1.5/1.75. Of total 20 patients, 10 (50.0%) patients experienced a seizure reduction of 50% or more, and one (5 %) of the responders became seizure-free in 6 months. Additional 14 patients, antiepileptic drugs of whose had been unchanged during 12 months, were reviewed. Eight (57%) of 14 patients experienced a seizure reduction of 50% or more in 12 months. The responder rates got increased as time goes on after the implantation of VNS generator.

Conclusions: Adjunctive VNS in intractable epilepsy associated with Dravet syndrome appears to reduce seizure frequency.

Aggressive procedure before severe disease develops, is recommended.


Keywords


Vagus nerve stimulation, Dravet syndrome, intractable epilepsy

Conference registration is required in order to view papers.