Single-center long-term results of vagus nerve stimulation for epilepsy: A 10-17 year follow-up study

CHRASTINA, Jan, Zdeněk NOVÁK, Tomáš ZEMAN, Jitka KOČVAROVÁ, Martin PAIL, Irena DOLEŽALOVÁ, Jiří JARKOVSKÝ and Milan BRÁZDIL. Single-center long-term results of vagus nerve stimulation for epilepsy: A 10-17 year follow-up study. Seizure-European journal of epilepsy. London: W.B. Saunders Ltd., 2018, vol. 59, JUL 2018, p. 41-47. ISSN 1059-1311. Available from: https://dx.doi.org/10.1016/j.seizure.2018.04.022.

Basic information

Original name

Single-center long-term results of vagus nerve stimulation for epilepsy: A 10-17 year follow-up study

Authors

CHRASTINA, Jan (203 Czech Republic, guarantor, belonging to the institution), Zdeněk NOVÁK (203 Czech Republic, belonging to the institution), Tomáš ZEMAN (203 Czech Republic, belonging to the institution), Jitka KOČVAROVÁ (203 Czech Republic, belonging to the institution), Martin PAIL (203 Czech Republic, belonging to the institution), Irena DOLEŽALOVÁ (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution) and Milan BRÁZDIL (203 Czech Republic, belonging to the institution)

Edition

Seizure-European journal of epilepsy, London, W.B. Saunders Ltd. 2018, 1059-1311

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Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.765

RIV identification code

RIV/00216224:14110/18:00104673

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.seizure.2018.04.022

UT WoS

000437818500009

Keywords in English

Epilepsy; Vagus nerve stimulation; Long term follow up; Responder; Battery replacement

Tags

14110127, 14110131, 14119612, podil, rivok

Tags

International impact, Reviewed

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Abstract

V originále

Purpose: The paper presents a long-term follow-up study of VNS patients, analyzing seizure outcome, medication changes, and surgical problems. Method: 74 adults with VMS for 10 to 17 years were evaluated yearly as: non-responder - NR (seizure frequency reduction <50%), responder - R (reduction >= 50% and <90%), and 90% responder - 90R (reduction >= 90%). Delayed R or 90R (>= 4 years after surgery), patients with antiepileptic medication changes and battery or complete system replacement were identified. Statistical analysis of potential outcome predictors (age, seizure duration, MRI, seizure type) was performed. Results: The rates of R and 90R related to the patients with outcome data available for the study years 1, 2, 10, and 17 were for R 38.4%, 51.4%, 63.6%, and 77.8%, and for 90R 1.4%, 5.6%, 15.1%, and 11.1%. The absolute numbers of R and 90R increased until years 2 and 6. Antiepileptic therapy was changed in 62 patients (87.9%). There were 11 delayed R and four delayed 90R, with medication changes in the majority. At least one battery replacement was performed in 51 patients (68.9%), 49 of whom R or 90R. VNS system was completely replaced in 7 patients (9.5%) and explanted in 7 NR (9.5%). No significant predictor of VNS outcome was found. Conclusions: After an initial increase, the rate of R and 90R remains stable in long-term follow-up. The changes of antiepileptic treatment in most patients potentially influence the outcome. Battery replacements or malfunctioning system exchange reflect the patient's satisfaction and correlate with good outcomes. (C) 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.