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Comparative Study
. 2019 Jun;58(2):255-264.
doi: 10.20471/acc.2019.58.02.08.

Efficacy and tolerability of vagus nerve stimulation therapy (VNS) in Slovenian epilepsy patients: younger age and shorter duration of epilepsy might result in better outcome

Alja Kavčič  1 , Nina Kajdič  1 , Zvonka Rener-Primec  1 , Natalija Krajnc  1 , Tomaž Žgur  1
Affiliations
Comparative Study

Efficacy and tolerability of vagus nerve stimulation therapy (VNS) in Slovenian epilepsy patients: younger age and shorter duration of epilepsy might result in better outcome

Alja Kavčič et al. Acta Clin Croat. 2019 Jun.

Abstract

To review the outcome of vagus nerve stimulation (VNS) therapy in all implanted Slovenian patients with drug-resistant epilepsy, data on 48 patients implanted between 2001 and 2015 were obtained retrospectively from medical records. The outcome was assessed in 2016. Out of 48 patients, 39 responded at follow up. The seizure frequency was reduced in 18 (46.2%) patients; 13 (33.3%) of them reported ≥50% reduction after 12 months of therapy. The responder rate was higher among patients implanted before the age of six years. Ictal severity decreased in 22 (56.4%), seizure duration in 19 (48.7%) and post-ictal recovery time in 22 (56.4%) patients. Favorable effects on the quality of life (QOL) were improved alertness in 33.3%, concentration in 41.0%, energy and mood in 38.5%, and memory in 17.9% of patients. Reduced seizure burden and improved QOL were more often observed in patients implanted at a younger age. Shorter duration of epilepsy was significantly associated with QOL improvement. Adverse effects were transient. Overall positive effects showed VNS to be a safe, well-tolerated and effective adjunctive treatment in most severe drug-resistant epilepsy patients. Implantation at a younger age and shorter duration of epilepsy before implantation could be important predictors of better outcome.

Keywords: Drug resistant epilepsy; Follow-up studies; Quality of life; Seizures; Slovenia; Vagus nerve stimulation.

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Figures

Fig. 1
Fig. 1
Percentages of patients with different seizure-related parameter outcomes after VNS implantation as reported at follow up in 2016. VNS = vagus nerve stimulation
Fig. 2
Fig. 2
Percentages of patients with improvement of seizure-related parameters in three different age groups at VNS implantation. VNS = vagus nerve stimulation
Fig. 3
Fig. 3
Seizure frequencies in 16 patients before and 3, 6 and 12 months after the onset of VNS (line represents the mean seizure frequency; shaded area denotes 95% confidence interval; the change in seizure frequency over time was calculated with generalized linear modeling using a bootstrap method). VNS = vagus nerve stimulation
Fig. 4
Fig. 4
Percentages of patients having showed improvement in QOL parameters in different age groups at VNS implantation. VNS = vagus nerve stimulation; QOL = quality of life
Fig. 5
Fig. 5
Percentages of patients having showed improvement in QOL parameters. Comparison of two groups according to duration of epilepsy before VNS implantation (<8 years and ≥8 years) revealed notable differences. VNS = vagus nerve stimulation; QOL = quality of life
Fig. 6
Fig. 6
Percentages of all adverse effects reported.
See this image and copyright information in PMC

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