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    
Abstract/OtherAbstract:
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.
Authors:
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
Related Documents :
21322467 - Idiopathic itch, rash, and urticaria/angioedema merit serum vitamin d evaluation: a des...
21296297 - Direct repair of spondylolysis presenting after correction of adolescent idiopathic sco...
21533997 - Dome osteotomy of the pelvis using a modified trochanteric osteotomy for acetabular dys...
21335007 - Iron levels in hepatocytes and portal tract cells predict progression and outcomes of p...
21212567 - Possible role of early transabdominal ultrasound in patients undergoing cytapheresis fo...
17636187 - Prophylaxis of venous thromboembolism in minor orthopedic surgery with parnaparin.
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.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Epilepsy / classification*,  therapy*
Female
Humans
Intelligence
Male
Middle Aged
Neuropsychological Tests
Prognosis
Retrospective Studies
Treatment Outcome
Vagus Nerve / physiology
Vagus Nerve Stimulation*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Maintaining binding in working memory: Comparing the effects of intentional goals and incidental aff...
Next Document:  Determining the technical and clinical factors associated with pain for children undergoing botulinu...