迷走神经刺激治疗难治性癫痫：长期疗效和副作用

Vagus nerve stimulation for refractory epilepsy: long term efficacy and side-effects.

作者信息

Hui Andrew Che Fai, Lam Joseph Man Kuen, Wong Ka Shing, Kay Richard, Poon Wai Sing

机构信息

Division of Neurology, Department of Medicine, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.

出版信息

Chin Med J (Engl). 2004 Jan;117(1):58-61.

PMID:14733774

Abstract

BACKGROUND

In general vagus nerve stimulation (VNS) can serve as an adjunctive treatment for patients with refractory partial-onset seizures. And we evaluated the long-term efficacy and safety of VNS in a group of Chinese patients with refractory epilepsy.

METHODS

Of 127 patients with refractory epilepsy, 13 patients who were not eligible for surgical intervention were implanted with the Cyberonics VNS system. Seizure frequency, physical examination and side effects profile were recorded at follow-up visits for a minimum of 18 months.

RESULTS

Mean duration of treatment was 47.4 months, and the longest follow-up period was 71 months. Mean baseline seizure frequency was 26.6 seizures per month. The mean percentage reductions in convulsions were 33.2%, 47.1% and 40.0% at 6, 12 and 18 months, respectively. One patient became seizure free, and six (46%) had 50% or more reduction in seizure frequency. Response was poor (< 20% reduction) in five patients (39%). Side effects were uncommon.

CONCLUSIONS

The effectiveness of VNS was sustained and was well tolerated but benefited only a sub-group of patients with intractable convulsions.

摘要

背景

一般来说，迷走神经刺激术（VNS）可作为难治性部分性发作患者的辅助治疗方法。我们评估了VNS在一组中国难治性癫痫患者中的长期疗效和安全性。

方法

在127例难治性癫痫患者中，13例不符合手术干预条件的患者植入了Cyberonics VNS系统。在随访至少18个月时记录癫痫发作频率、体格检查和副作用情况。

结果

平均治疗时间为47.4个月，最长随访期为71个月。平均基线癫痫发作频率为每月26.6次。在6个月、12个月和18个月时，惊厥平均减少百分比分别为33.2%、47.1%和40.0%。1例患者癫痫发作停止，6例（46%）癫痫发作频率降低50%或更多。5例患者（39%）反应较差（降低<20%）。副作用不常见。