迷走神经刺激术治疗耐药性癫痫——45 例病例回顾。

Treatment of drug-resistant epilepsy with vagus nerve stimulation -- review of 45 cases.

机构信息

Department of Functional Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.

出版信息

Chin Med J (Engl). 2011 Dec;124(24):4184-8.

Abstract

BACKGROUND

Vagus nerve stimulation (VNS) is an alternative treatment for drug-resistant epilepsy (DRE). The study aimed to explore the potential factors of prognosis, safety and effect of VNS treatment in patients with DRE.

METHODS

We retrospectively examined 45 cases of DRE that received VNS treatment in our center from June 2004 to June 2010 and analyzed the parameters (age of patient receiving VNS, seizure frequency before and after VNS as well as treatment duration) by Student's t test, Fisher's exact and Mann-Whitney U tests, and multivariate Logistic regression.

RESULTS

The overall response rate was 64% (29/45), 67% (6/9) for adults and 64% (23/36) for children, with no significant difference (P = 0.28). Twenty-two cases had been in VNS therapy for over 1 year with a treatment efficacy of 73% (16/22), whereas 23 cases had been in VNS therapy no more than 1 year with a treatment effecacy of 57% (13/23), and has statistically significant difference (P = 0.03). The main side effect included hoarseness of voice and cough. One patient's device was removed due to infection. One patient's VNS was half-way terminated due to seizure aggravation. One patient died due to status epilepticus.

CONCLUSIONS

VNS is a safe and effective treatment for DRE. Duration of VNS therapy may be a crucial factor on prognosis.

摘要

背景

迷走神经刺激（VNS）是一种治疗耐药性癫痫（DRE）的替代疗法。本研究旨在探讨 VNS 治疗 DRE 患者的预后、安全性和效果的潜在因素。

方法

我们回顾性检查了 2004 年 6 月至 2010 年 6 月期间在我们中心接受 VNS 治疗的 45 例 DRE 患者，并通过学生 t 检验、Fisher 确切检验和 Mann-Whitney U 检验分析了参数（接受 VNS 治疗的患者年龄、VNS 前后的癫痫发作频率以及治疗持续时间），并进行了多变量 Logistic 回归分析。

结果

总体反应率为 64%（29/45），成人组为 67%（6/9），儿童组为 64%（23/36），差异无统计学意义（P=0.28）。22 例 VNS 治疗时间超过 1 年，治疗有效率为 73%（16/22），而 23 例 VNS 治疗时间不超过 1 年，治疗有效率为 57%（13/23），差异有统计学意义（P=0.03）。主要副作用包括声音嘶哑和咳嗽。1 例患者因感染而取出设备。1 例患者因癫痫发作加重而中途终止 VNS。1 例患者因癫痫持续状态死亡。