ICNC Abstracts, ICNC 2018

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Vagal Nerve Stimulation treatment in children with pharmaco-resistant epilepsy: A single centre experience
Mazen Haider, Helen McCullagh, Gayatri Vadlamani, Janet Kellett, Gopalakrishnan Venkatachalam

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.

 


Keywords


Vagl Nerve Stimulation (VNS), EPILEPSY, Autistic Spectrum Disorder (ASD), Anti Epileptic Drugs (AEDs),

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