Gedela Satyanarayana, Sitwat Bilal, Welch William P, Krafty Robert T, Sogawa Yoshimi
Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH, United States.
Division of Pediatric Neurology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States.
Seizure. 2018 Feb;55:66-69. doi: 10.1016/j.seizure.2018.01.010. Epub 2018 Feb 3.
This study explores the effect of Vagus Nerve Stimulator (VNS) on Status Epilepticus (SE) in children with medically intractable epilepsy.
Retrospective review was conducted in children with a history of at least two SE, who had VNS implantation and had at least one year follow up after the procedure.
Sixteen patients met inclusion/exclusion criteria. The median age of seizure onset and surgery was 1.3 years and 9.0 years, respectively. Prior to VNS implantation, 81% (13/16) of patients had ≥one seizure per month when all seizure types were combined. 75% (12/16) of patients experienced ≥one generalized convulsive seizure per month. The median number of SE prior to VNS was three (2-9), and 63% (10/16) had at least one SE during a year prior to implantation. The proportion of patients who did not have any SE one year after VNS implantation increased compared to the year prior (75% vs. 37%, p = 0.07). The seizure frequency decreased in a minority of patients when all seizure types were combined (20% at one year, p = 1.00, 44% at the last follow up, p = 0.55), but generalized convulsive seizure decreased in 69% of patients at one year (p = 0.01) and 75% of patients at last follow up (p = 0.01).
VNS appears to have favorable impact on SE and generalized convulsive seizures in children with medically intractable epilepsy.
本研究探讨迷走神经刺激器（VNS）对药物难治性癫痫患儿癫痫持续状态（SE）的影响。
对有至少两次SE病史、接受了VNS植入且术后至少随访一年的患儿进行回顾性研究。
16例患者符合纳入/排除标准。癫痫发作起始和手术的中位年龄分别为1.3岁和9.0岁。在VNS植入前，当合并所有癫痫发作类型时，81%（13/16）的患者每月发作≥1次。75%（12/16）的患者每月经历≥1次全身性惊厥发作。VNS植入前SE的中位次数为3次（2 - 9次），63%（10/16）的患者在植入前一年至少有一次SE。与植入前一年相比，VNS植入后一年无任何SE的患者比例有所增加（75%对37%，p = 0.07）。当合并所有癫痫发作类型时，少数患者的癫痫发作频率降低（一年时为20%，p = 1.00，末次随访时为44%，p = 0.55），但一年时69%的患者全身性惊厥发作减少（p = 0.01），末次随访时75%的患者全身性惊厥发作减少（p = 0.01）。
VNS似乎对药物难治性癫痫患儿的SE和全身性惊厥发作有积极影响。
