Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 5918-5925
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.5918
Preliminary analysis of the effect of vagus nerve stimulation in the treatment of children with intractable epilepsy
Tie Fang, Zi-Hang Xie, Ting-Hong Liu, Jie Deng, Shuai Chen, Feng Chen, Li-Li Zheng
Tie Fang, Zi-Hang Xie, Ting-Hong Liu, Jie Deng, Shuai Chen, Feng Chen, Li-Li Zheng, Department of Functional Neurosurgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100056, China
Author contributions: Fang T and Xie ZH contributed equally to this article and should be considered as co-first authors; Fang T and Xie ZH performed the operation; Liu TH and Deng J designed this retrospective study; Chen S and Chen F wrote this paper; Zheng LL was responsible for sorting the data.
Institutional review board statement: The study was reviewed and approved by the Beijing Children’s Hospital affiliated to Capital Medical University Institutional Review Board, Approval No. IEC-C-008-A08-V.05.1.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tie Fang, MD, Associate Chief Physician, Department of Functional Neurosurgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nanlishi Road, Xicheng District, Beijing 100056, China. victorft369@hotmail.com
Received: June 29, 2020
Peer-review started: June 29, 2020
First decision: August 8, 2020
Revised: August 29, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: December 6, 2020
Processing time: 157 Days and 22.9 Hours
Abstract
BACKGROUND

Implant vagus nerve stimulation is an adjunctive treatment for intractable epilepsy when patients are not suitable for resective surgery.

AIM

To identify the safety and efficacy of vagus nerve stimulation in children with intractable epilepsy and analyze the effects on different epilepsy syndromes.

METHODS

Eligible children with intractable epilepsy were admitted to the study. We collected data from preoperative assessments as the baseline. During the follow-up time, we recorded the process of seizures (frequency, duration, and seizure type), the changes of drugs or parameters, the complications, etc. The mean reduction rate of seizures, response rate, and McHugh scale were chosen as the outcomes.

RESULTS

A total of 213 patients were implanted with Tsinghua Pins vagus nerve stimulators, and the average age was 6.6 years. In the follow-up time of postoperative 3 mo, 6 mo, 12 mo, 18 mo, and 24 mo, the average reduction rate was 30.2%, 49.5%, 56.3%, 59.4%, and 63.2%, while the response rate was 21.8%, 62.5%, 57.1%, 69.2%, and 70.7%. In addition, implanted vagus nerve stimulation had different effects on epilepsy syndromes. The reduction rate of West syndrome increased from 36.4% (postoperative 6 m) to 74.3% (postoperative 24 m). The reduction rate of Lennox-Gastaut syndrome improved from 25.4% to 73.1% in 24 mo. The chi-square test of the five efficacy grades showed P < 0.05. The comparison between the 3-mo follow-up and the 6-mo follow-up showed P < 0.05, and the comparison between the 6-mo follow-up and the 24-mo follow-up showed P > 0.05.

CONCLUSION

Vagus nerve stimulation is safe and effective in children with intractable epilepsy, and the seizure reduction occurred in a time-dependent manner. Moreover, patients with West syndrome may get the most benefits.

Keywords: Vagus nerve, Stimulation, Children, Intractable epilepsy, Epilepsy syndrome, Operation

Core Tip: We provided a preliminary analysis of the safety and efficacy of implanted vagus nerve stimulation in the treatment of refractory epilepsy in children.