Lead revision surgery for vagus nerve stimulation in epilepsy: outcomes and efficacy

Abstract

We present, to our knowledge, the first published analysis of vagus nerve stimulation (VNS) lead revisions to incorporate quality of life, clinical response, and antiepileptic drug (AED) burden in postrevision clinical outcomes. Ten patients were followed and had no postoperative complications. Seven patients had improvement in quality of life, and three experienced no change. Eight patients noted a restoration of clinical response comparable with initial VNS implantation. Seven patients reported 30-60% improvement in seizure reduction, two experienced >60%, and one noted <30%. Six patients had no change in AED burden. Vagus nerve stimulation lead revision should be considered a safe option for patients with VNS lead failure and medically intractable epilepsy.

Keywords: AED; Epilepsy surgery; Intractable epilepsy; Lead revision; Seizure disorder; VNS; Vagus nerve stimulation; antiepileptic drug; vagus nerve stimulation.