Hueng-Chuen Fan1, Ting-Rong Hsu2, Kai-Ping Chang2, Shyi-Jou Chen3, Jeng-Dau Tsai4. 1. Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, Taichung, Taiwan. 2. Department of Pediatrics, Taipei Veterans General Hospital, Taiwan; Faculty of Medicine, National Yang-Ming University,Taiwan. 3. Department of Pediatrics, Tri-Service General Hospital, Taiwan. 4. School of Medicine and Department of Pediatrics, Chung Shan Medical University and Hospital, Taichung, Taiwan. Electronic address: fernand.tsai@msa.hinet.net.
Abstract
OBJECTIVES: Refractory epilepsy (RE) is frequently associated with neuropsychological impairment in children and may disrupt their social development. Vagus nerve stimulation (VNS) had been reported to have beneficial effects on behavioral outcomes. The aim of this study was to compare Parenting Stress Index (PSI) scores before and after VNS device implantation in children with RE, especially those who experienced seizure frequency reduction. METHODS: We conducted a one-group pretest-posttest study in school age children with RE. Seizure frequency and PSI were recorded at 12months after VNS device implantation. RESULTS: Treatment with VNS was significantly associated with reduced seizure frequency and parental stress as measured by PSI. Factors contributing to seizure frequency included idiopathic/cryptogenic etiology and neurobehavioral comorbidities. In children with reduced seizure frequency, statistically significant improvements in the child domain of the PSI on the subscales of mood and reinforces parent were found. In the parent domain, the scores for social isolation were reduced. CONCLUSIONS: Treatment with VNS was significantly associated with reduced seizure frequency and improved PSI scores, especially within the child domain on the mood and reinforces parent subscales. These findings suggest that VNS reduced not only seizure frequency but also the psychological burden on children with RE.
OBJECTIVES: Refractory epilepsy (RE) is frequently associated with neuropsychological impairment in children and may disrupt their social development. Vagus nerve stimulation (VNS) had been reported to have beneficial effects on behavioral outcomes. The aim of this study was to compare Parenting Stress Index (PSI) scores before and after VNS device implantation in children with RE, especially those who experienced seizure frequency reduction. METHODS: We conducted a one-group pretest-posttest study in school age children with RE. Seizure frequency and PSI were recorded at 12months after VNS device implantation. RESULTS: Treatment with VNS was significantly associated with reduced seizure frequency and parental stress as measured by PSI. Factors contributing to seizure frequency included idiopathic/cryptogenic etiology and neurobehavioral comorbidities. In children with reduced seizure frequency, statistically significant improvements in the child domain of the PSI on the subscales of mood and reinforces parent were found. In the parent domain, the scores for social isolation were reduced. CONCLUSIONS: Treatment with VNS was significantly associated with reduced seizure frequency and improved PSI scores, especially within the child domain on the mood and reinforces parent subscales. These findings suggest that VNS reduced not only seizure frequency but also the psychological burden on children with RE.
Authors: S Grasl; S Janik; A Dressler; R Diehm; G Gröppel; K Eichinger; M C Grasl; W Gstoettner; M Feucht; E Vyskocil; W D Baumgartner Journal: Eur Arch Otorhinolaryngol Date: 2021-07-01 Impact factor: 2.503