Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan
Background: Vagus nerve stimulation (VNS) is used as an add-on treatment for epilepsy. This study aimed to use Taiwanese nationwide registry data to analyze the therapeutic effects of VNS in children with refractory epilepsy (RE) and try to explore predictive factors of VNS treatment effectiveness....
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Elsevier
2020-12-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957220301108 |
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| author | Sung-Tse Li Nan-Chang Chiu Kun-Long Hung Che-Sheng Ho Yung-Ting Kuo Wen-Hsiang Wu Chuan-Yu Wang Yung-Ting Kuo Huei-Shyong Wang Kuang-Lin Lin Po-Cheng Hung Ying-Chao Chang Pi-Lien Hung Pi-Chuan Fan Wang-Tso Lee Rei-Cheng Yang Fang-Jong Ko Lung-Chang Lin Po-Ching Chou Jeng-Dau Tsai Kun-Long Hung Hui-Ju Chen Kai-Ping Chang Ting-Rong Hsu Che-Sheng Ho Nan-Chang Chiu Shyi-Jou Chen Hueng-Chuen Fan Hsu-Tung Lee Ein-Yiao Shen Huang-Tsung Kuo Ming-Yuh Chang Tung-Ming Chang Sung-Tse Li Geng-Chang Yeh |
| author_facet | Sung-Tse Li Nan-Chang Chiu Kun-Long Hung Che-Sheng Ho Yung-Ting Kuo Wen-Hsiang Wu Chuan-Yu Wang Yung-Ting Kuo Huei-Shyong Wang Kuang-Lin Lin Po-Cheng Hung Ying-Chao Chang Pi-Lien Hung Pi-Chuan Fan Wang-Tso Lee Rei-Cheng Yang Fang-Jong Ko Lung-Chang Lin Po-Ching Chou Jeng-Dau Tsai Kun-Long Hung Hui-Ju Chen Kai-Ping Chang Ting-Rong Hsu Che-Sheng Ho Nan-Chang Chiu Shyi-Jou Chen Hueng-Chuen Fan Hsu-Tung Lee Ein-Yiao Shen Huang-Tsung Kuo Ming-Yuh Chang Tung-Ming Chang Sung-Tse Li Geng-Chang Yeh |
| author_sort | Sung-Tse Li |
| collection | DOAJ |
| description | Background: Vagus nerve stimulation (VNS) is used as an add-on treatment for epilepsy. This study aimed to use Taiwanese nationwide registry data to analyze the therapeutic effects of VNS in children with refractory epilepsy (RE) and try to explore predictive factors of VNS treatment effectiveness. Methods: This retrospective study collected data from December 2007 to December 2014. Patient variables included gender, age, VNS implantation date, epilepsy duration, seizure frequency, seizure type, etiology, and antiepileptic drug (AED) history. We divided patients into three groups: Group I as seizure frequency >80 times per month, Group II as seizure frequency 24–80 times per month, and Group III as seizure frequency <24 times per month. Multivariate regression analysis was performed to determine predictors of seizure frequency reduction after VNS treatment. Results: A total of 80 patients were included in this study. Three or more AED types were prescribed for 61 (77.1%) patients. Seizure frequency decreased significantly at 12 and 24 months after VNS treatment. The mean seizure reduction rates were 44.6% and 50.1% at 12 and 24 months after VNS treatment, with the difference between them reaching statistical significance (p = 0.001). In multivariate linear regression, high seizure frequency (Group I) was a positive predictor of seizure frequency reduction (p < 0.001). The most common complication was coughing (eight patients, 10%) and no patient had early withdrawal or premature termination of VNS use due to complications. Conclusion: VNS is an effective palliative treatment for children with RE for different seizure types. Seizure reduction rate at 24 months after VNS was better than at 12 months after VNS. High seizure frequency can be regarded as a positive predictor for seizure frequency reduction in children with RE treated with VNS. |
| format | Article |
| id | doaj-art-434ea8fa49c448ca9cd153d58e7b7dbe |
| institution | DOAJ |
| issn | 1875-9572 |
| language | English |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-434ea8fa49c448ca9cd153d58e7b7dbe2025-08-20T02:55:16ZengElsevierPediatrics and Neonatology1875-95722020-12-0161660661210.1016/j.pedneo.2020.07.010Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in TaiwanSung-Tse Li0Nan-Chang Chiu1Kun-Long Hung2Che-Sheng Ho3Yung-Ting Kuo4Wen-Hsiang Wu5Chuan-Yu Wang6Yung-Ting Kuo7Huei-Shyong Wang8Kuang-Lin Lin9Po-Cheng Hung10Ying-Chao Chang11Pi-Lien Hung12Pi-Chuan Fan13Wang-Tso Lee14Rei-Cheng Yang15Fang-Jong Ko16Lung-Chang Lin17Po-Ching Chou18Jeng-Dau Tsai19Kun-Long Hung20Hui-Ju Chen21Kai-Ping Chang22Ting-Rong Hsu23Che-Sheng Ho24Nan-Chang Chiu25Shyi-Jou Chen26Hueng-Chuen Fan27Hsu-Tung Lee28Ein-Yiao Shen29Huang-Tsung Kuo30Ming-Yuh Chang31Tung-Ming Chang32Sung-Tse Li33Geng-Chang Yeh34Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan; Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, TaiwanDepartment of Medicine, Mackay Medical College, New Taipei City, Taiwan; Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Corresponding author. Department of Pediatrics, MacKay Children’s Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei City, 10449, Taiwan. Fax: +886 2 2543 3642.Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan; Department of Pediatrics, Fu-Jen Catholic University Hospital, New Taipei City, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, TaiwanDepartment of Medicine, Mackay Medical College, New Taipei City, Taiwan; Department of Pediatrics, MacKay Children's Hospital, Taipei, TaiwanDepartment of Pediatrics, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, TaiwanDepartment of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, TaiwanDepartment of Pediatrics, Taipei Medical University-Shuang Ho Hospital, New Taipei City, TaiwanDepartment of Pediatrics, Taipei Medical University-Shuang Ho Hospital, New Taipei City, TaiwanDivision of Pediatric Neurology, Chang Gung Children's Hospital, Taoyuan, TaiwanDivision of Pediatric Neurology, Chang Gung Children's Hospital, Taoyuan, TaiwanDivision of Pediatric Neurology, Chang Gung Children's Hospital, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital Kaohsiung, Kaohsiung City, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital Kaohsiung, Kaohsiung City, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, New Taipei City, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, New Taipei City, TaiwanDepartment of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung City, TaiwanDepartment of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung City, TaiwanDepartment of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung City, TaiwanDepartment of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung City, TaiwanDepartment of Pediatrics, Chung Shang Medical University Hospital, Taichung City, TaiwanDepartment of Pediatrics, Cathay General Hospital, Taipei City, TaiwanDepartment of Pediatrics, Cathay General Hospital, Taipei City, TaiwanDepartment of Pediatrics, Taipei Veterans General Hospital, Taipei City, TaiwanDepartment of Pediatrics, Taipei Veterans General Hospital, Taipei City, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Hsinchu, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Hsinchu, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, Taipei City, TaiwanDepartment of Pediatrics, Tri-Service General Hospital, Taipei City, TaiwanDepartment of Neurosurgery, Taichung Veterans General Hospital, Taichung City, TaiwanDepartment of Pediatrics, China Medical University Hospital, Taichung City, TaiwanDepartment of Pediatrics, China Medical University Hospital, Taichung City, TaiwanDepartment of Pediatrics, Changhua Christian Hospital, Changhua City, TaiwanDepartment of Pediatrics, Changhua Christian Hospital, Changhua City, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Hsinchu, TaiwanDepartment of Pediatrics, Taipei Medical University Hospital, Taipei City, TaiwanBackground: Vagus nerve stimulation (VNS) is used as an add-on treatment for epilepsy. This study aimed to use Taiwanese nationwide registry data to analyze the therapeutic effects of VNS in children with refractory epilepsy (RE) and try to explore predictive factors of VNS treatment effectiveness. Methods: This retrospective study collected data from December 2007 to December 2014. Patient variables included gender, age, VNS implantation date, epilepsy duration, seizure frequency, seizure type, etiology, and antiepileptic drug (AED) history. We divided patients into three groups: Group I as seizure frequency >80 times per month, Group II as seizure frequency 24–80 times per month, and Group III as seizure frequency <24 times per month. Multivariate regression analysis was performed to determine predictors of seizure frequency reduction after VNS treatment. Results: A total of 80 patients were included in this study. Three or more AED types were prescribed for 61 (77.1%) patients. Seizure frequency decreased significantly at 12 and 24 months after VNS treatment. The mean seizure reduction rates were 44.6% and 50.1% at 12 and 24 months after VNS treatment, with the difference between them reaching statistical significance (p = 0.001). In multivariate linear regression, high seizure frequency (Group I) was a positive predictor of seizure frequency reduction (p < 0.001). The most common complication was coughing (eight patients, 10%) and no patient had early withdrawal or premature termination of VNS use due to complications. Conclusion: VNS is an effective palliative treatment for children with RE for different seizure types. Seizure reduction rate at 24 months after VNS was better than at 12 months after VNS. High seizure frequency can be regarded as a positive predictor for seizure frequency reduction in children with RE treated with VNS.http://www.sciencedirect.com/science/article/pii/S1875957220301108childrenrefractory epilepsyvagus nerve stimulation |
| spellingShingle | Sung-Tse Li Nan-Chang Chiu Kun-Long Hung Che-Sheng Ho Yung-Ting Kuo Wen-Hsiang Wu Chuan-Yu Wang Yung-Ting Kuo Huei-Shyong Wang Kuang-Lin Lin Po-Cheng Hung Ying-Chao Chang Pi-Lien Hung Pi-Chuan Fan Wang-Tso Lee Rei-Cheng Yang Fang-Jong Ko Lung-Chang Lin Po-Ching Chou Jeng-Dau Tsai Kun-Long Hung Hui-Ju Chen Kai-Ping Chang Ting-Rong Hsu Che-Sheng Ho Nan-Chang Chiu Shyi-Jou Chen Hueng-Chuen Fan Hsu-Tung Lee Ein-Yiao Shen Huang-Tsung Kuo Ming-Yuh Chang Tung-Ming Chang Sung-Tse Li Geng-Chang Yeh Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan Pediatrics and Neonatology children refractory epilepsy vagus nerve stimulation |
| title | Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan |
| title_full | Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan |
| title_fullStr | Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan |
| title_full_unstemmed | Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan |
| title_short | Therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in Taiwan |
| title_sort | therapeutic effects of children with refractory epilepsy after vagus nerve stimulation in taiwan |
| topic | children refractory epilepsy vagus nerve stimulation |
| url | http://www.sciencedirect.com/science/article/pii/S1875957220301108 |
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