Abstracts

Rationale: The incidence of unprovoked and recurrent seizures after previous central nervous infections is high and accounts for 1–5% of patients with epilepsy. Children with viral encephalitis have a ten-fold increase in the risk of developing epilepsy, and the seizures are generally intractable. Neuropsychological testing in the patients with intractable postencephalitic epilepsy (IPE) often reveals diffuse brain dysfunction, and the EEG often detects multiple epileptogenic foci, which are negative prognostic factors for seizure remission. In severely affected patients with IPE who have evidence of bilateral or diffuse disease, the outcome after surgery is usually disappointing, even after extensive localization studies using invasive intracranial techniques. For patients with IPE with surgical contraindication, vagus nerve stimulation (VNS) may be a palliative therapy. The purpose of our study was to assess the efficacy on seizures of VNS in patients with IPE. Methods: Our study reviewed files of 35 children treated with VNS between May, 2011 and December, 2018 in our center. Data was collected from baseline to 12, 24 months of follow-up. Results: At 6, 12, 24 months follow-up, 37.14%, 57.14%, 66.67% of the patients with IPE, achieved response on seizure frequency (reduction >50%) respectively, including 2.56%, 8.57%, 12.50% were seizure-free respectively. In addition, EEG with mutifocal discharge demonstrated as a marker for higher responder without reaching to statistical significance. MR negative indicated as a marker for higher responder without reaching to statistica significance. Conclusions: VNS implantation provides an efficacy therapy in decreasing the seizures frequency in patients with IPE. The rate of responders and rate of seizures free increase over time respectively. Funding: This Project was supported by the Grant from the National Natural ScienceFoundation of China (81571275)