Aris Hadjinicolaou1, Puneet Jain2, Ravindra Arya3, Celie Roth4, Robyn Whitney5, Ivanna Yau6, Hansel M Greiner7, Francesco T Mangano8, James T Rutka9, Cristina Go10. 1. Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children (University of Toronto), Toronto, Ontario, M5G 1X8, Canada. Electronic address: aris.hadjinicolaou@sickkids.ca. 2. Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children (University of Toronto), Toronto, Ontario, M5G 1X8, Canada. Electronic address: puneet.jain@sickkids.ca. 3. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: ravindra.arya@cchmc.org. 4. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: roth.celie@gmail.com. 5. Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children (University of Toronto), Toronto, Ontario, M5G 1X8, Canada. Electronic address: robyn.whitney@sickkids.ca. 6. Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children (University of Toronto), Toronto, Ontario, M5G 1X8, Canada. Electronic address: ivanna.yau@sickkids.ca. 7. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: hansel.greiner@cchmc.org. 8. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: francesco.mangano@cchmc.org. 9. Division of Neurosurgery, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada. Electronic address: james.rutka@sickkids.ca. 10. Epilepsy Program, Division of Neurology, Department of Pediatrics, The Hospital for Sick Children (University of Toronto), Toronto, Ontario, M5G 1X8, Canada. Electronic address: cristina.go@sickkids.ca.
Abstract
PURPOSE: This study evaluated the seizure outcomes in children with drug-resistant epilepsy (DRE), having a pre-existing VNS device, after generator replacement with cardiac-based VNS device. METHODS: This retrospective study enrolled 30 children with DRE from 2 centers with an existing VNS device nearing end-of-service who underwent generator replacement with cardiac-based VNS device and had at least 1 year follow up. Seizure outcomes and adverse effects were studied. RESULTS: The mean age at insertion of cardiac-based VNS device was 15.03 years. 26.7 % patients showed at least one class improvement at last follow up (mean 2.08 years) and half of the patients maintained their McHugh seizure-outcome class. Thirty-six percent of patients had > 50 % seizure reduction at last follow up. Ten patients reported improvement in ictal severity. Most of the patients tolerated the replacement well. CONCLUSIONS: Nearly one-third of patients with DRE showed additional improvement after replacement with cardiac based VNS device. Half of the patients maintained their seizure control.
PURPOSE: This study evaluated the seizure outcomes in children with drug-resistant epilepsy (DRE), having a pre-existing VNS device, after generator replacement with cardiac-based VNS device. METHODS: This retrospective study enrolled 30 children with DRE from 2 centers with an existing VNS device nearing end-of-service who underwent generator replacement with cardiac-based VNS device and had at least 1 year follow up. Seizure outcomes and adverse effects were studied. RESULTS: The mean age at insertion of cardiac-based VNS device was 15.03 years. 26.7 % patients showed at least one class improvement at last follow up (mean 2.08 years) and half of the patients maintained their McHugh seizure-outcome class. Thirty-six percent of patients had > 50 % seizure reduction at last follow up. Ten patients reported improvement in ictal severity. Most of the patients tolerated the replacement well. CONCLUSIONS: Nearly one-third of patients with DRE showed additional improvement after replacement with cardiac based VNS device. Half of the patients maintained their seizure control.
Authors: Breanne Fisher; Julie A DesMarteau; Elizabeth H Koontz; Seth J Wilks; Susan E Melamed Journal: Front Neurol Date: 2021-01-15 Impact factor: 4.003
Authors: Arjune Sen; Ryan Verner; James P Valeriano; Ricky Lee; Muhammad Zafar; Rhys Thomas; Katarzyna Kotulska; Ellen Jespers; Maxine Dibué; Patrick Kwan Journal: BMJ Neurol Open Date: 2021-12-23