Centro de Cirurgia de Epilepsia (CIREP), Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, SP, Brazil.
Division of Stereotactic and Functional Neurosurgery, University Hospital Freiburg, Freiburg im Breisgau, Germany.
Epilepsy Behav. 2014 Feb;31:329-33. doi: 10.1016/j.yebeh.2013.10.011. Epub 2013 Nov 5.
Vagus nerve stimulation (VNS) seems to be effective in the management of selected cases of pharmacoresistant epilepsy in children. This was a case-control prospective study of children with refractory epilepsy submitted to vagal nerve stimulator implantation and a control group with epilepsy treated with antiepileptic drugs. Patients under 18years of age who underwent clinical or surgical treatment because of pharmacoresistant epilepsy from January 2009 to January 2012 were followed and compared with an age-matched control group at final evaluation. Statistically significant differences were observed considering age at epilepsy onset (VNS group - 1.33±1.45years; controls - 3.23±3.11; p=0.0001), abnormal findings in neurological examination (p=0.01), history of previous ineffective epilepsy surgery (p=0.03), and baseline seizure frequency (p=0.0001). At long-term follow-up, 55.4% of the patients in the VNS group had at least 50% reduction of seizure frequency, with 11.1% of the patients presenting 95% reduction on seizure frequency. Also, a decrease in traumas and hospitalization due to seizures and a subjective improvement in mood and alertness were observed. The control group did not show a significant modification in seizure frequency during the study. In this series, VNS patients evolved with a statistically significant reduction of the number of seizures, a decreased morbidity of the seizures, and the number of days in inpatient care. In accordance with the current literature, VNS has been proven to be an effective alternative in the treatment of pediatric patients with drug-resistant epilepsy.
迷走神经刺激（VNS）似乎对儿童耐药性癫痫的某些病例的治疗有效。这是一项针对接受迷走神经刺激器植入的耐药性癫痫儿童和接受抗癫痫药物治疗的癫痫对照组的病例对照前瞻性研究。2009 年 1 月至 2012 年 1 月，对因耐药性癫痫而接受临床或手术治疗的 18 岁以下患者进行了随访，并在最终评估时与年龄匹配的对照组进行了比较。观察到以下方面存在统计学显著差异：癫痫发作年龄（VNS 组 - 1.33±1.45 岁；对照组 - 3.23±3.11 岁；p=0.0001）、神经检查异常（p=0.01）、既往无效癫痫手术史（p=0.03）和基线发作频率（p=0.0001）。在长期随访中，VNS 组中有 55.4%的患者发作频率至少降低了 50%，其中 11.1%的患者发作频率降低了 95%。此外，还观察到由于癫痫发作而导致的创伤和住院次数减少，以及情绪和警觉性的主观改善。对照组在研究期间癫痫发作频率没有明显变化。在本系列中，VNS 患者的发作次数、癫痫发作的发病率以及住院天数均有统计学显著减少。根据当前文献，VNS 已被证明是治疗耐药性癫痫儿童的有效替代方法。
