In a cohort of 42 children younger than 12, vagus nerve stimulation reduced seizures and improved mood and alertness over five years.
ROME—Young children with intractable epilepsy benefited from vagus nerve stimulation (VNS) for a period of five years, according to research presented at the 29th International Epilepsy Congress.
Although VNS is approved for children older than 12 with intractable epilepsy, it often is used in younger children, said Lubov Romantseva, MD, Assistant Professor at Rush University Medical Center in Chicago, and colleagues. There is increasing focus on the role of VNS for preadolescent children with intractable epilepsy, they noted.
The researchers performed a retrospective review of 42 patients with epilepsy who received VNS implantation when they were younger than 12. All patients had the stimulator device implanted at the University of Chicago from January 2002 to May 2009 and were followed for a minimum of six months and up to five years after implantation. The investigators looked specifically at the percent of seizure decrease experienced by the patients from baseline.
“Our study found results similar to those of other studies in young children and were as good as the pivotal studies in adults,” study coauthor Michael H. Kohrman, MD, Professor of Pediatrics, Neurology, and Neurosurgery at the University of Chicago, told Neurology Reviews.
The patients received VNS implantation at a mean age of 5.73 years. Of this group, 28 (67%) had at least a 50% decrease in frequency of seizures. In addition, 21 (50%) patients experienced a 75% decrease in seizures and three (7%) patients became free of seizures. “Most of the seizure reduction was achieved within the first six months of VNS therapy,” the researchers noted. Improvements in mood and alertness were reported by 69% of patients.
The outcome was not significantly influenced by age at VNS implantation, duration of epilepsy before implantation, or EEG focality. Seven percent of patients reported complications, which included cough, gag, hypopnea, dystonia, and delayed surgical site infection.
“VNS therapy in preadolescent children with intractable epilepsy is effective and safe,” the researchers concluded. “Larger-scale studies are needed to evaluate predictors of greatest VNS response in this vulnerable group of children.”
—Jack Baney