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Is vagus nerve stimulation a treatment option for
patients with drug-resistant idiopathic generalized epilepsy?
Department of Neurodiagnostics,
National Centre
for Epilepsy, Division of Clinical Neuroscience, Rikshospitalet
University Hospital Oslo, Norway.
Background - The value of vagus nerve
stimulation
(VNS) for treating patients with drug-resistant idiopathic generalized
epilepsy (IGE) is not well documented. Patients and methods - Twelve
patients (2 males, 10 females) with a mean age of 31 years (11-48
years) and with drug-resistant IGE had VNS implanted in the period
1995-2006. All had generalized seizures documented by
video-electroencephalogram. Mean follow-up period was 23 months (9-54
months). Results - There was a total seizure reduction of 61% (P =
0.0002). There was 62% reduction of generalized tonic-clonic seizures
(P = 0.0020), 58% of absences (P = 0.0003) and 40% of myoclonic
seizures (P = 0.0156). Eight patients were considered responders
(>50% seizure reduction); two of these patients became seizure-free.
Five out of seven patients with juvenile myoclonic epilepsy were
responders. At the last follow-up visit, the patients had reduced the
anti-epileptic drug (AED) usage from an average of 2.3 to 1.7 AED per
patient (P = 0.0625). Two patients are currently being treated with VNS
therapy only. Nine patients reported side effects, which were mostly
mild and tended to diminish over time. Conclusion - Our results
indicate that adjunctive VNS therapy is a favourable treatment option
for patients with drug-resistant IGE. Rapid cycling seems worth trying
in some of the non-responders.
PMID: 17419830 [PubMed - in process]
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