Document Detail

Efficacy of vagus nerve stimulation for refractory epilepsy among patient subgroups: a re-analysis using the Engel classification.
MedLine Citation:
PMID:  21273097     Owner:  NLM     Status:  MEDLINE    
Optimal candidates for VNS as a treatment for refractory epilepsy have not been identified. In this retrospective two-center study, we used the Engel classification for evaluating seizure outcome, and tried to identify predictive factors for outcome by means of subgroup analysis. The medical records of patients who have been treated with VNS for at least one year at Dartmouth-Hitchcock Medical Center and Ghent University Hospital were evaluated. Seizure frequency outcome was assessed using the Engel classification for the study population as a whole, and for patient subgroups with regard to mental functioning, seizure type, predisposing factors for developing epilepsy, age at time of VNS implantation and epilepsy duration. 189 patients (102M/87F) were included in the study (mean FU: 41 months). 6% had a class I outcome (seizure-free), 13% a class II outcome (almost seizure-free), 49% a class III outcome (worthwhile improvement) and 32% had a class IV outcome (no improvement). When patients were divided into specific subgroups, a statistically significant better outcome was found patients with normal mental functioning (p=0.029). In our series, results for VNS are clearly inferior to resective surgery, but comparable to other treatment modalities for refractory epilepsy. With combined class I and II outcomes around 20%, and another 50% of patients having worthwhile improvement, VNS is a viable alternative when resective surgery is not feasible.
Marcus Wheeler; Veerle De Herdt; Kristl Vonck; Karen Gilbert; Suneetha Manem; Todd Mackenzie; Barbara Jobst; David Roberts; Peter Williamson; Dirk Van Roost; Paul Boon; Vijay Thadani
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2011-01-26
Journal Detail:
Title:  Seizure     Volume:  20     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-12     Completed Date:  2011-08-03     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 British Epilepsy Association. All rights reserved.
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MeSH Terms
Child, Preschool
Epilepsy / classification*,  therapy*
Middle Aged
Neuropsychological Tests
Retrospective Studies
Treatment Outcome
Vagus Nerve / physiology
Vagus Nerve Stimulation*
Young Adult

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