Vagus nerve stimulation in children with intractable epilepsy: a randomized controlled trial

Sylvia Klinkenberg*, Marlien W. Aalbers, Johan S. H. Vles, Erwin M. J. Cornips, Kim Rijkers, Loes Leenen, Fons G. H. Kessels, Albert P. Aldenkamp, Marian Majoie

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Aim The aim of this study was to evaluate the effects of vagus nerve stimulation (VNS) in children with intractable epilepsy on seizure frequency and severity and in terms of tolerability and safety. Method In this study, the first randomized active controlled trial of its kind in children, 41 children (23 males; 18 females; mean age at implantation 11y 2mo, SD 4y 2mo, range 3y 10mo17y 8mo) were included. Thirty-five participants had localization-related epilepsy (25 symptomatic; 10 cryptogenic), while six participants had generalized epilepsy (four symptomatic; two idiopathic). During a baseline period of 12 weeks, seizure frequency and severity were recorded using seizure diaries and the adapted Chalfont Seizure Severity Scale (NHS3), after which the participants entered a blinded active controlled phase of 20 weeks. During this phase, half of the participants received high-output VNS (maximally 1.75mA) and the other half received low-output stimulation (0.25mA). Finally, all participants received high-output stimulation for 19 weeks. For both phases, seizure frequency and severity were assessed as during the baseline period. Overall satisfaction and adverse events were assessed by semi-structured interviews. Results At the end of the randomized controlled blinded phase, seizure frequency reduction of 50% or more occurred in 16% of the high-output stimulation group and in 21% of the low-output stimulation group (p=1.00). There was no significant difference in the decrease in seizure severity between participants in the stimulation groups. Overall, VNS reduced seizure frequency by 50% or more in 26% of participants at the end of the add-on phase The overall seizure severity also improved (p

Original languageEnglish
Pages (from-to)855-861
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Volume54
Issue number9
DOIs
Publication statusPublished - Sep-2012
Externally publishedYes

Keywords

  • LENNOX-GASTAUT-SYNDROME
  • REFRACTORY EPILEPSY
  • FOLLOW-UP
  • PEDIATRIC EPILEPSY
  • RESISTANT EPILEPSY
  • PARTIAL SEIZURES
  • THERAPY
  • COMPLICATIONS
  • BEHAVIOR
  • EXPERIENCE

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