Grioni Daniele, Landi Andrea, Gasperini Serena, Trezza Andrea, Fiori Leonardo, Rigoldi Miriam, Parini Rossella, Sganzerla Erik Pietro
Child Neuropsychiatric Clinic, S. Gerardo Hospital, University of Milan Bicocca, Monza, Italy.
Neurosurgery Clinic, S. Gerardo Hospital, University of Milan Bicocca, Monza, Italy.
Child Neurol Open. 2015 Oct 25;2(4):2329048X15612432. doi: 10.1177/2329048X15612432. eCollection 2015 Oct-Dec.
Patients affected by inborn errors of metabolism can develop catastrophic epilepsies ineligible for resective surgery. Few reports concerning vagal nerve stimulation in patients with epileptic encephalopathy in the context of metabolic diseases have been published in the literature. Drug-resistant epilepsies in metabolic disease could be a specific target for vagal nerve stimulation, although the efficacy of this technique in these patients still needs to be proved. The authors report our experience in treating refractory epilepsy with vagal nerve stimulation in 2 patients affected by inborn errors of metabolism. The first patient is a 23-year-old patient affected by glutaric aciduria type II, the other one is a 16-month-old child with nonketotic hyperglycinemia. Vagal nerve stimulation reduced seizures up to 50% in the first case and up to 90% in the second one.
患有先天性代谢缺陷的患者可能会发展出灾难性癫痫，不适合进行切除性手术。关于在代谢性疾病背景下癫痫性脑病患者进行迷走神经刺激的报道在文献中很少见。代谢性疾病中的耐药性癫痫可能是迷走神经刺激的一个特定靶点，尽管该技术在这些患者中的疗效仍有待证实。作者报告了我们对2例患有先天性代谢缺陷的患者进行迷走神经刺激治疗难治性癫痫的经验。第一例患者是一名23岁患有II型戊二酸尿症的患者，另一例是一名16个月大患有非酮症高甘氨酸血症的儿童。迷走神经刺激使第一例患者的癫痫发作减少了50%，第二例减少了90%。
