J 2018

Older Age and Longer Epilepsy Duration Do Not Predict Worse Seizure Reduction Outcome after Vagus Nerve Stimulation

CHRASTINA, Jan, Jitka KOČVAROVÁ, Zdeněk NOVÁK, Irena DOLEŽALOVÁ, Michal SVOBODA et. al.

Basic information

Original name

Older Age and Longer Epilepsy Duration Do Not Predict Worse Seizure Reduction Outcome after Vagus Nerve Stimulation

Authors

CHRASTINA, Jan (203 Czech Republic, guarantor, belonging to the institution), Jitka KOČVAROVÁ (203 Czech Republic, belonging to the institution), Zdeněk NOVÁK (203 Czech Republic, belonging to the institution), Irena DOLEŽALOVÁ (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution) and Milan BRÁZDIL (203 Czech Republic, belonging to the institution)

Edition

Journal of Neurological Surgery, Part A: Central European Neurosurgery, New York, Thieme Medical Publ Inc, 2018, 2193-6315

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.060

RIV identification code

RIV/00216224:14110/18:00104102

Organization unit

Faculty of Medicine

DOI

UT WoS

000426299500008

Keywords in English

epilepsy; vagus nerve stimulation; seizures reduction; responder

Tags

Tags

International impact, Reviewed
Změněno: 12/3/2019 13:21, Mgr. Pavla Foltynová, Ph.D.

Abstract

V originále

Introduction We analyzed the results of vagus nerve stimulation (VNS) on older patients and patients with long-lasting epilepsy and included severely intellectually disabled patients. Patients and Methods A total of 103 adults with VNS implanted from 2005 to 2014 were studied. The responder rates, that is, the percentage of VNS patients who responded to VNS, classified as seizure reduction50% (50R) and seizure reduction90% (90R), were compared in defined age groups (< 40 and40 years, and<50 and50 years) and epilepsy duration groups (< 20 and20 years,<30 and30 years, and<40 and40 years) at the 1-year follow-up visit and the last follow-up visit (at least 2 years after surgery). The age distributions and responder rates were also studied in patients with an intellectual disability. Results The analysis did not confirm a significantly lower 50R or 90R rate in patients40,50, or60 years when compared with their younger counterparts, but the 50R rate increase during follow-up care was the lowest in patients50 and60 years. The highest percentage of patients with an intellectual disability in the group<40 years of age did not adversely affect the 50R rate. Longer epilepsy duration was not confirmed as a negative predictor of VNS outcome. There was a significantly higher 50R rate in patients with epilepsy duration20 years (at the last follow-up visit) and a higher 90R rate in patients with epilepsy duration30 years (at the 1-year follow-up visit). The increase in the 50R rate during follow-up care was lower in patients with epilepsy durations30 and40 years. Conclusions The study did not find worse VNS outcomes, as defined by the 50R or 90R rate, in older adult patients or in patients with a longer epilepsy duration. The increasing stimulation effect over time is less marked in older patients and in patients with longer epilepsy duration.