Outcomes of vagal nerve stimulation in a pediatric population: a single center experience

Abstract

Objective: To evaluate the efficacy of vagus nerve stimulation (VNS) in pediatric patients with medically refractory epilepsy.

Method: We reviewed the medical records of 252 consecutive patients who underwent VNS implantation at a single center over a 5-year period. Patients with complete 6- and 12-month follow-up data were included. Analysis was also done across various subgroups including gender, age at implantation, seizure type, abnormal MRI findings pre-implantation, number of medications at baseline, history of SE, and duration of epilepsy.

Results: Complete follow-up data were available for 69 patients. Median seizure reduction for these patients was 50% (Q1: 0%; Q3: 73%) at 6 months and 40% (Q1: -25%; Q3: 75%) at 12 months. When stratified by baseline seizure frequency, there was a significant reduction from baseline of 61% at 6 months and 69% at 12 months for patients in the high-baseline frequency group. There were no significant reductions at month 6 or 12 months for the lower-baseline frequency group. Adverse events were reported in 40.6% (28 out of 69 patients). Six patients had the VNS removed for reasons including lack of efficacy and side effects and were excluded from the study group.

Conclusion: VNS provides significant seizure reduction, in particular in pediatric patients with a higher baseline seizure frequency.

Keywords: Brain stimulation; Cranial Nerve; Efficacy; Epilepsy; Medically refractory epilepsy; Outcome; Pediatric; Seizure; Seizure control; Stimulation; Vagus nerve stimulation.