Efficacy of Vagal Nerve Stimulation in Adult Patients: Experience of a Young Epilepsy Outpatient Clinic

Abstract

Objectives: Antiepileptic drugs are the most commonly used treatments in epilepsy. However, in a group of about one-third of all epilepsy patients who have not been able to control seizures with antiepileptic drugs called drug-resistant epilepsy, epilepsy surgery, VNS (vagal nerve stimulation), neurostimulation, and the ketogenic diet are important treatment modalities. In this study, the patients who had refractory epilepsy and had VNS were reviewed retrospectively, and the results were evaluated. Methods: Patients who were followed-up with VNS in our clinic between July 2014 and January 2019 were evaluated in this study. Demographic and clinical features of the patients and seizure outcome after VNS were reviewed. Results: Seventeen patients who underwent vagal nerve stimulation were enrolled in this study. Three of these patients were VNS in the external centers and the patients we followed in our clinic. Eight (47.1%) of the patients were male, and nine (52.9%) were female; average age 32 +/- 8.40 years; (minimum 19 years, maximum 52 years).The mean age of VNS was 28.06 +/- 8.37 years, and the mean follow-up period after VNS was 38.82 +/- 14.67 months.The seizure of 52.9% of the patients degreased by more than 50%, 11.8% had no change in seizure frequency, 35.3% less than 50% improved. Cognitive improvement was observed in 47.1% of the patients. Conclusion: VNS is an important treatment modality in this group of patients to alleviate the frequency and the severity of the seizures, and to provide cognitive and behavioral improvement in drug-resistant epilepsy patients.