The preliminary analysis of clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy in children_Journal of Epilepsy

Authors：

WANG Zhongming ^1,2 , WANG Qin ¹ , PENG Qiong ¹ , HUANG Yahui ¹ , LI Zhenguang ¹ , CHEN Pan ¹ ,  LU Jun ^1,2

1. Epilepsy Center, Hunan Brain Hospital, the Second People’s Hospital of Hunan Province, Changsha 410073, China;
2. Clinical School of Medicine, Hunan University of Chinese Medicine, Changsha 410073, China;

Corresponding?author：

LU Jun, Email: 53558059@qq.com

Keywords：

Vagus nerve stimulation; Children; Refractory epilepsy; Surgical treatment

DOI：

10.7507/2096-0247.202406011

Video：

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Objective To investigate the efficacy of vagus nerve stimulation (VNS) in the treatment of refractory epilepsy in children and the key factors affecting its efficacy. Methods The clinical data of 22 children with drug-resistant epilepsy who received VNS treatment in the Second People's Hospital of Hunan Province from January 2016 to April 2023 were analyzed. The average seizure reduction rate, effective rate and McHugh grade were used to evaluate the efficacy of VNS after at least 1 year follow-up. Patients with an attack reduction rate of ≥50% were defined as respondents, and Mann-Witney U test and χ² test were used, respectively, to conduct univariate and multifactor Logistics regression analysis with statistically significant indicators (P<0.05). Results Among the 22 patients, the average attack reduction rate was 12.66% at 1 month, 26.10% at 3 months, 37.47% at 6 months, 48.18% at 9 months and 54.38% at 12 months. The effective rate was 5.00%, 9.00%, 36.00%, 50.00% and 68.00%, respectively. 12 months after operation, there were 3 cases of grade I, 12 cases of grade II, 7 cases of grade III, and 0 cases of grade V. Unifactorial and multivariate Logistic regression analysis showed that the curative effect of epilepsy in children was related to the seizure type, among which the curative effect of general seizure was better than that of focal seizure (OR=0.062, P=0.014), and the curative effect of myoclonic seizure and tonic seizure was better than that of other types in general seizure. Conclusion The clinical effect of VNS in the treatment of refractory epilepsy in children is time cumulative, and the surgical effect of myoclonic seizures and tonic seizures in general seizures is better.

Citation： WANG Zhongming, WANG Qin, PENG Qiong, HUANG Yahui, LI Zhenguang, CHEN Pan, LU Jun. The preliminary analysis of clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy in children. Journal of Epilepsy, 2024, 10(5): 398-403. doi: 10.7507/2096-0247.202406011 Copy

1.	王薇薇, 吳遜. 腦網絡理論在癲癇臨床中的意義及應用. 癲癇雜志, 2024, 10(1): 66-72.
2.	許子驁. 通過DTI分析丘腦-皮層結構連接與藥物難治性癲癇患者行迷走神經刺激術療效的關系. 安徽醫科大學, 2023, 碩士學位論文.
3.	顧銳, 紀凡, 朱晉. 迷走神經刺激術治療兒童癲癇的療效預測因素分析. 臨床神經外科雜志, 2022, 19(5): 488-491,496.
4.	周晶晶, 賈圣陶, 張曉華, 等. 迷走神經刺激術治療5例難治性抑郁癥患者的療效及安全性分析. 神經疾病與精神衛生, 2022, 22(3): 172-176.
5.	郭永坤, 趙德梟, 劉春穎, 等. 迷走神經刺激術治療藥物難治性癲癇. 中華神經創傷外科電子雜志, 2021, 7(6): 383-384.
6.	譚泊靜, 李云林, 馬康平, 等. 迷走神經刺激術治療SCN1A基因異常相關兒童難治性癲癇5例并文獻復習. 立體定向和功能性神經外科雜志, 2021, 34(3): 141-144.
7.	曾媛香, 胡越. 迷走神經刺激術治療兒童難治性癲癇的研究進展. 癲癇雜志, 2021, 7(1): 49-53.
8.	Fang JJ, Shan W, Wu JP, et al. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neuroscience & Therapeutics, 2019, 25(11): 1222-1228.
9.	張桐, 湯繼宏. 迷走神經刺激術治療兒童藥物難治性癲癇的研究進展. 癲癇雜志, 2019, 5(6): 463-466.
10.	曾媛香. 迷走神經刺激術治療兒童藥物難治性癲癇的有效性及安全性分析. 重慶醫科大學, 2021, 碩士學位論文.
11.	Tufo T , Izzo A , Fuggetta M , et al. Retrospective open-label study of efficacy and tolerability of vagus nerve stimulation (VNS) for treatment of drug-resistant epilepsy: long-term follow up. Journal of the Neurological Sciences, 2019, 405 (Suppl): 121-121.
12.	向迅捷, 孫留中, 徐才邦, 等. 迷走神經電刺激術治療難治性癲癇的臨床療效觀察. 廣西醫學, 2019, 41(14): 1843-1845.
13.	Alja K , Nina K , Zvonka R , et al. Efficacy and tolerability of vagus nerve stimulation therapy (VNS) in Slovenian epilepsy patients: younger age and shorter duration of epilepsy might result in better outcome. Acta clinica Croatica, 2019, 58(2): 255-264.
14.	González FH , Yengo-Kahn A , Englot JD . Vagus nerve stimulation for the treatment of epilepsy . Neurosurgery Clinics of North America, 2019, 30 (2): 219-230.
15.	王嫻, 李莉萍, 遇濤, 等. 植入式迷走神經刺激治療難治性癲癇的有效性分析. 中華神經科雜志, 2018, 51(10): 819-823.
16.	李瀟嘯, 孫濤, 劉陽, 等. 迷走神經刺激術在兒童藥物難治性癲癇中的應用. 寧夏醫科大學學報, 2018, 40(3): 323-326.
17.	方鐵, 方方, 張杰, 等. 迷走神經刺激治療兒童難治性癲癇的初步療效分析. 中華神經外科疾病研究雜志, 2017, 16(5): 407-411.

1. 王薇薇, 吳遜. 腦網絡理論在癲癇臨床中的意義及應用. 癲癇雜志, 2024, 10(1): 66-72.
2. 許子驁. 通過DTI分析丘腦-皮層結構連接與藥物難治性癲癇患者行迷走神經刺激術療效的關系. 安徽醫科大學, 2023, 碩士學位論文.
3. 顧銳, 紀凡, 朱晉. 迷走神經刺激術治療兒童癲癇的療效預測因素分析. 臨床神經外科雜志, 2022, 19(5): 488-491,496.
4. 周晶晶, 賈圣陶, 張曉華, 等. 迷走神經刺激術治療5例難治性抑郁癥患者的療效及安全性分析. 神經疾病與精神衛生, 2022, 22(3): 172-176.
5. 郭永坤, 趙德梟, 劉春穎, 等. 迷走神經刺激術治療藥物難治性癲癇. 中華神經創傷外科電子雜志, 2021, 7(6): 383-384.
6. 譚泊靜, 李云林, 馬康平, 等. 迷走神經刺激術治療SCN1A基因異常相關兒童難治性癲癇5例并文獻復習. 立體定向和功能性神經外科雜志, 2021, 34(3): 141-144.
7. 曾媛香, 胡越. 迷走神經刺激術治療兒童難治性癲癇的研究進展. 癲癇雜志, 2021, 7(1): 49-53.
8. Fang JJ, Shan W, Wu JP, et al. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neuroscience & Therapeutics, 2019, 25(11): 1222-1228.
9. 張桐, 湯繼宏. 迷走神經刺激術治療兒童藥物難治性癲癇的研究進展. 癲癇雜志, 2019, 5(6): 463-466.
10. 曾媛香. 迷走神經刺激術治療兒童藥物難治性癲癇的有效性及安全性分析. 重慶醫科大學, 2021, 碩士學位論文.
11. Tufo T , Izzo A , Fuggetta M , et al. Retrospective open-label study of efficacy and tolerability of vagus nerve stimulation (VNS) for treatment of drug-resistant epilepsy: long-term follow up. Journal of the Neurological Sciences, 2019, 405 (Suppl): 121-121.
12. 向迅捷, 孫留中, 徐才邦, 等. 迷走神經電刺激術治療難治性癲癇的臨床療效觀察. 廣西醫學, 2019, 41(14): 1843-1845.
13. Alja K , Nina K , Zvonka R , et al. Efficacy and tolerability of vagus nerve stimulation therapy (VNS) in Slovenian epilepsy patients: younger age and shorter duration of epilepsy might result in better outcome. Acta clinica Croatica, 2019, 58(2): 255-264.
14. González FH , Yengo-Kahn A , Englot JD . Vagus nerve stimulation for the treatment of epilepsy . Neurosurgery Clinics of North America, 2019, 30 (2): 219-230.
15. 王嫻, 李莉萍, 遇濤, 等. 植入式迷走神經刺激治療難治性癲癇的有效性分析. 中華神經科雜志, 2018, 51(10): 819-823.
16. 李瀟嘯, 孫濤, 劉陽, 等. 迷走神經刺激術在兒童藥物難治性癲癇中的應用. 寧夏醫科大學學報, 2018, 40(3): 323-326.
17. 方鐵, 方方, 張杰, 等. 迷走神經刺激治療兒童難治性癲癇的初步療效分析. 中華神經外科疾病研究雜志, 2017, 16(5): 407-411.

Journal of Epilepsy

The preliminary analysis of clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy in children

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