Luis Fernandez1, Satyanarayana Gedela2, Mandeep Tamber3, Yoshimi Sogawa4. 1. Division of Child Neurology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States. 2. Division of Child Neurology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States; University of Pittsburgh, School of Medicine, Department of Pediatrics and Neurology, Pittsburgh, PA, United States. 3. University of Pittsburgh, School of Medicine, Department of Neurosurgery, Pittsburgh, PA, United States. 4. Division of Child Neurology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States; University of Pittsburgh, School of Medicine, Department of Pediatrics and Neurology, Pittsburgh, PA, United States. Electronic address: Yoshimi.Sogawa@chp.edu.
Abstract
OBJECTIVE: To describe the characteristics of children less than three years of age with medically intractable epilepsy, who underwent Vagus Nerve Stimulator (VNS) therapy at Children's Hospital of Pittsburgh between 2004 and 2011. METHODS: Retrospective chart review. RESULTS: Seventeen patients were identified; adequate follow-up was available for 15. Median follow up duration was 4.3 years (1.4-10.2 years). 12/15 (80%) had a known etiology for their epilepsy. All patients had more than 1 seizure per week prior to VNS and a history of status epilepticus was frequent (40%, 6/15). Five patients (33%) reported improved seizure frequency at one year after VNS. A normal MRI was associated with seizure improvement (p=0.007). No patient had status epilepticus after VNS at one-year follow-up. At three years after VNS, four patients had experienced status epilepticus with only one patient experiencing multiple episodes. Complications were seen in 2/15 (13%) patients and in 2/21 (9.5%) procedures. SIGNIFICANCE: A normal MRI was associated with seizure improvement at one year in children less than three years of age at the time of VNS implant. The degree of overall seizure reduction was modest, but the frequency of status epilepticus was decreased after VNS implant. VNS was tolerated well in this age group.
OBJECTIVE: To describe the characteristics of children less than three years of age with medically intractable epilepsy, who underwent Vagus Nerve Stimulator (VNS) therapy at Children's Hospital of Pittsburgh between 2004 and 2011. METHODS: Retrospective chart review. RESULTS: Seventeen patients were identified; adequate follow-up was available for 15. Median follow up duration was 4.3 years (1.4-10.2 years). 12/15 (80%) had a known etiology for their epilepsy. All patients had more than 1 seizure per week prior to VNS and a history of status epilepticus was frequent (40%, 6/15). Five patients (33%) reported improved seizure frequency at one year after VNS. A normal MRI was associated with seizure improvement (p=0.007). No patient had status epilepticus after VNS at one-year follow-up. At three years after VNS, four patients had experienced status epilepticus with only one patient experiencing multiple episodes. Complications were seen in 2/15 (13%) patients and in 2/21 (9.5%) procedures. SIGNIFICANCE: A normal MRI was associated with seizure improvement at one year in children less than three years of age at the time of VNS implant. The degree of overall seizure reduction was modest, but the frequency of status epilepticus was decreased after VNS implant. VNS was tolerated well in this age group.
Authors: Brian J Dlouhy; Brandon Miller; Anna Jeong; Mary E Bertrand; David D Limbrick; Matthew D Smyth Journal: Childs Nerv Syst Date: 2016-07-27 Impact factor: 1.475
Authors: Carlo Efisio Marras; Gabriella Colicchio; Luca De Palma; Alessandro De Benedictis; Giancarlo Di Gennaro; Marilou Cavaliere; Elisabetta Cesaroni; Alessandro Consales; Sofia Asioli; Massimo Caulo; Flavio Villani; Nelia Zamponi Journal: Int J Environ Res Public Health Date: 2020-08-24 Impact factor: 3.390