Seizures in Tuberous Sclerosis Treated with Vagal Nerve Stimulation
Abstract number :
3.215
Submission category :
Year :
2000
Submission ID :
2480
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Jerome V Murphy, Dominique Parain, Marie Josee Penniello, Patrick Berquen, Thierry Delange, Catherine Billard, Children's Mercy Hosp, Kansas City, MO; Ctr Hospitalier Univ (CHU), Rouen, France; CHU, Caen, France; CHU, Amiens, France; CHU, Rouen, France; C
RATIONALE: Intermittent stimulation of the left vagal nerve (VNS)is a novel and efficacious therapy in the treatment of medically refractory epilepsy. Seizures refractory to medical management are not an infrequent problem in patients with tuberous sclerosis. METHODS: Ten tuberous sclerosis patients whose seizures were not controlled by at least 5 available antiepileptic drugs were treated with VNS utilizing an implanted generator with leads attached to the left vagal nerve. Pre-VNS the seizure frequency varied from 3 to 17 (mean = 8) daily. Seizure types included generalized tonic clonic, myoclonic, and complex partial. Ages at implant were 6 to 20 years (mean = 13), and seizures had started in the first two years of life in all patients. RESULTS: No patients had complete cessation of seizures. Five had > 90% reduction in seizure frequency, one had 80-90% reduction, and 3 had 50-80% reduction in seizure frequency. One patient continued having 7 seizures daily despite VNS. Improvement was seen within the first month of VNS and never subsequently deteriorated. No complications were recognized. CONCLUSIONS: VNS appears to be an effective and well tolerated therapy in patients with medically refractory epilepsy.