Abstracts

The Lennox-Gastaut syndrome (LGS) is widely known as one of the most severe and prognostically unfavourable epileptic conditions. When medications fail, nonpharmacologic treatments should be considered such as the ketogenic diet, epilepsy surgery (corpus callosotomy), and vagus nerve stimulation (VNS) Therapy., A retrospective analysis of data from Cyberonics[apos] International Patient Registry showed 29 patients (18 male, 11 female) with LGS who were treated with vagus nerve stimulation (VNS) Therapy between May 1994 and September 2001. Patients had a mean age of 16.6 years (range, 4-34). A total of 5 patients were institutionalized, and 7 patients had a history of callosotomy. Twenty-six patients (89.6%) were mentally retarded/developmentally delayed. Patients were taking an average of 2.45 antiepileptic drugs (AEDs) per patient. Mean follow-up was 48.6 months. Data related to seizure reduction, AEDs and quality of life (QoL) were analysed., There was a total median seizure reduction of 60%, and a total mean seizure reduction of 45.9% (p[lt]0.0001). A total of 41.4% of the patients (N=12) had [ge] 50% seizure reduction. A reduction in the total number of AEDs was also observed (-0.52 AEDs/patient; p=0.0293). Median stimulation parameters at last follow-up visit were: output current, 1.25 mA; pulse width, 500 [micro]s; frequency, 30 Hz; time [apos]on[apos], 30 sec; time [apos]off[apos], 5 minutes. Six patients (20.7%) reported that the magnet was always or most of the time effective in aborting or reducing the intensity and/or duration of their seizures. QoL improvements were more pronounced for alertness (48.3%), post-ictal state (37.9%) and cluster seizures (34.5%)., These results show that VNS Therapy allowed a significant reduction in seizure frequency and in total number of AEDs in this patient population with LGS. VNS Therapy was also associated with QoL improvements.,