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儿童局灶性癫痫的长期迷走神经刺激。

Long-term vagus nerve stimulation in children with focal epilepsy.

机构信息

Department of Child Neurology, Epilepsy Center Brno, Faculty of Medicine, Brno University Hospital, Masaryk University, Czech Republic.

出版信息

Acta Neurol Scand. 2013 May;127(5):316-22. doi: 10.1111/ane.12009. Epub 2012 Sep 20.

Abstract

OBJECTIVES

The aim of the study was to evaluate the long-term efficacy and hospitalization rates in children with refractory focal epilepsy treated by vagus nerve stimulation.

MATERIALS AND METHODS

We retrospectively analyzed 15 children with intractable focal epilepsy treated by vagus nerve stimulation (mean age of 14.6 ± 2.5 years at the time of implantation). We analyzed the treatment effectiveness at 1, 2, and 5 year follow-up visits. We counted the average number of urgent hospitalizations and number of days of urgent hospitalization per year for each patient before and after the VNS implantation.

RESULTS

The mean seizure reduction was 42.5% at 1 year, 54.9% at 2 years, and 58.3% at 5 years. The number of responders was 7 (46.7%) at 1 year and 9 (60%) at both 2 and 5 years. The mean number of urgent hospitalizations per patient was 1.0 ± 0.6 per year preoperatively and 0.3 ± 0.5 per year post-operatively (P < 0.0001). The mean number of days of urgent hospitalization per patient was 9.3 ± 6.1 per year preoperatively and 1.3 ± 1.8 per year post-operatively ( < 0.0001).

CONCLUSIONS

Vagus nerve stimulation is an effective method of treating children with refractory focal epilepsy. It leads to a substantial decrease in the number and duration of urgent hospitalizations.

摘要

目的

本研究旨在评估迷走神经刺激治疗耐药性局灶性癫痫儿童的长期疗效和住院率。

材料和方法

我们回顾性分析了 15 例接受迷走神经刺激治疗的耐药性局灶性癫痫儿童(植入时的平均年龄为 14.6 ± 2.5 岁)。我们分析了 1 年、2 年和 5 年随访时的治疗效果。我们统计了每位患者在 VNS 植入前后每年的紧急住院次数和紧急住院天数。

结果

1 年时的平均癫痫发作减少率为 42.5%,2 年时为 54.9%,5 年时为 58.3%。1 年时的应答者人数为 7 例(46.7%),2 年和 5 年均为 9 例(60%)。每位患者的平均紧急住院次数为术前每年 1.0 ± 0.6 次,术后每年 0.3 ± 0.5 次(P < 0.0001)。每位患者的平均紧急住院天数为术前每年 9.3 ± 6.1 天,术后每年 1.3 ± 1.8 天(P < 0.0001)。

结论

迷走神经刺激是治疗耐药性局灶性癫痫儿童的有效方法。它可显著减少紧急住院的次数和时间。

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