Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy
Background and Objectives: In this study, we aimed to assess the long-term outcome of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE). Methods: A retrospective analysis of outcome data of 24 patients with DRE, who had been implanted with VNS and had at least 5 years of p...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Annals of Indian Academy of Neurology |
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| Online Access: | https://journals.lww.com/10.4103/aian.aian_389_24 |
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| author | Anuja Patil Sita Jayalakshmi Shanmukhi Somayajula Dhrumil Shah Sudhindra Vooturi Manas Panigrahi |
| author_facet | Anuja Patil Sita Jayalakshmi Shanmukhi Somayajula Dhrumil Shah Sudhindra Vooturi Manas Panigrahi |
| author_sort | Anuja Patil |
| collection | DOAJ |
| description | Background and Objectives:
In this study, we aimed to assess the long-term outcome of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE).
Methods:
A retrospective analysis of outcome data of 24 patients with DRE, who had been implanted with VNS and had at least 5 years of post-surgery follow-up was performed. The seizure outcome at the latest follow-up was classified as class I–V as proposed by John C. McHugh. The cognitive, psychiatric, and behavioral outcomes were recorded using standardized tests.
Results:
Mean age at the time of VNS implantation was 18.7 (6–38) years; nine (37.5%) of the patients were females. Mean duration of epilepsy was 13.6 years (range: 2.5–35 years); 18 (75%) patients had multiple (≥2) seizure types and 15 (62.5%) had daily seizures. The most common etiology was perinatal hypoxic injury (15, 62.5%). More than 50% seizure reduction (class 1 and 2) was noted in 54.2% of patients at 1 year, which increased to 75% at ≥5 years follow-up. A significantly higher number of patients with other etiologies had >50% reduction in seizures at the latest follow-up, when compared to those with hypoxic–ischemic encephalopathy (53.3% vs. 100%, P = 0.0024). The average intelligence quotient (IQ; 71.17 ± 28.92 vs. 64.65 ± 29.61, P = 0.014) and quality of life (66.64 ± 14.63 vs. 64.65 ± 29.61, P < 0.001) scores were significantly higher in patients post-VNS implantation, when compared to their baseline scores. Furthermore, significant number of patients had improvement in psychiatric diagnosis (29.2% vs. 4.2%, P = 0.047) and behavioral problems (50% vs. 4.2%, P < 0.001) post-VNS implantation.
Conclusions:
The present study shows >50% seizure reduction in 75% of patients after VNS implantation at long-term follow-up, with improvement in IQ, quality of life, psychiatric and behavioral problems. |
| format | Article |
| id | doaj-art-3118b0a13d5145bb8e48f176894efa1f |
| institution | DOAJ |
| issn | 0972-2327 1998-3549 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj-art-3118b0a13d5145bb8e48f176894efa1f2025-08-20T03:16:35ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492025-01-01281323710.4103/aian.aian_389_24Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant EpilepsyAnuja PatilSita JayalakshmiShanmukhi SomayajulaDhrumil ShahSudhindra VooturiManas PanigrahiBackground and Objectives: In this study, we aimed to assess the long-term outcome of vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE). Methods: A retrospective analysis of outcome data of 24 patients with DRE, who had been implanted with VNS and had at least 5 years of post-surgery follow-up was performed. The seizure outcome at the latest follow-up was classified as class I–V as proposed by John C. McHugh. The cognitive, psychiatric, and behavioral outcomes were recorded using standardized tests. Results: Mean age at the time of VNS implantation was 18.7 (6–38) years; nine (37.5%) of the patients were females. Mean duration of epilepsy was 13.6 years (range: 2.5–35 years); 18 (75%) patients had multiple (≥2) seizure types and 15 (62.5%) had daily seizures. The most common etiology was perinatal hypoxic injury (15, 62.5%). More than 50% seizure reduction (class 1 and 2) was noted in 54.2% of patients at 1 year, which increased to 75% at ≥5 years follow-up. A significantly higher number of patients with other etiologies had >50% reduction in seizures at the latest follow-up, when compared to those with hypoxic–ischemic encephalopathy (53.3% vs. 100%, P = 0.0024). The average intelligence quotient (IQ; 71.17 ± 28.92 vs. 64.65 ± 29.61, P = 0.014) and quality of life (66.64 ± 14.63 vs. 64.65 ± 29.61, P < 0.001) scores were significantly higher in patients post-VNS implantation, when compared to their baseline scores. Furthermore, significant number of patients had improvement in psychiatric diagnosis (29.2% vs. 4.2%, P = 0.047) and behavioral problems (50% vs. 4.2%, P < 0.001) post-VNS implantation. Conclusions: The present study shows >50% seizure reduction in 75% of patients after VNS implantation at long-term follow-up, with improvement in IQ, quality of life, psychiatric and behavioral problems.https://journals.lww.com/10.4103/aian.aian_389_24vagus nerve stimulationdrug-resistant epilepsyoutcomecognitionbehavior |
| spellingShingle | Anuja Patil Sita Jayalakshmi Shanmukhi Somayajula Dhrumil Shah Sudhindra Vooturi Manas Panigrahi Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy Annals of Indian Academy of Neurology vagus nerve stimulation drug-resistant epilepsy outcome cognition behavior |
| title | Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy |
| title_full | Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy |
| title_fullStr | Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy |
| title_full_unstemmed | Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy |
| title_short | Long-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy |
| title_sort | long term outcome of vagus nerve stimulation for drug resistant epilepsy |
| topic | vagus nerve stimulation drug-resistant epilepsy outcome cognition behavior |
| url | https://journals.lww.com/10.4103/aian.aian_389_24 |
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