Ekmekci Hakan, Kaptan Hulagu
Selcuk University, School of Medicine, Department of Neurology, Konya, Turkey.
Turk Neurosurg. 2019;29(2):213-221. doi: 10.5137/1019-5149.JTN.23065-18.4.
To evaluate the resistant epileptic patients who had vagal nerve stimulation (VNS) devices implanted over five years, and to evaluate the neuropsychological aspects of VNS.
Patients with pharmacoresistant epilepsy (PRE) were followed from 2012 to 2017. Totally seven patients were found eligible for VNS in this period. In the pre-surgical period, patients were neuro-psychiatrically assessed by an independent psychiatric committee for mental status, which included assessment of intelligence quotient (IQ), Wechsler adult intelligence scale-revised (WAIS-R) IQ, Stroop test and mini-mental state examination (MMSE), Hamilton depression scale (HDS) and the Beck anxiety inventory (BAI).
The positive effects of VNS on patients' well-being and neuropsychiatric status may be the most as important as the treatment's cost effectiveness. The patients' quality of life (QoL) was calculated just before and 12th / 24th months after VNS implantation. The pre-VNS scores for Quality of Life in Epilepsy (QoLiE-31-P) ranged from 14-59, and average score was 37.14.The post-VNS scores ranged from 31-72, and the average score was 52.86.
VNS has intense effects on QoL of epileptic patients. The best approach for comparing and evaluating QoL in PRE patients may be the QoLiE-31-P inventory, which can be adapted and used in epilepsy centers to evaluate energy, mood, daily activity, cognition, medication effects, seizure worry and overall QoL.
评估植入迷走神经刺激(VNS)装置超过五年的耐药癫痫患者,并评估VNS的神经心理学方面。
对2012年至2017年的药物难治性癫痫(PRE)患者进行随访。在此期间,共发现7例患者符合VNS治疗条件。在手术前期,由独立的精神科委员会对患者进行神经精神状态评估,包括智商(IQ)评估、韦氏成人智力量表修订版(WAIS-R)智商评估、斯特鲁普测验和简易精神状态检查(MMSE)、汉密尔顿抑郁量表(HDS)和贝克焦虑量表(BAI)。
VNS对患者幸福感和神经精神状态的积极影响可能与治疗的成本效益同样重要。在VNS植入前及植入后12/24个月计算患者的生活质量(QoL)。癫痫生活质量量表(QoLiE-31-P)的VNS植入前评分范围为14-59,平均评分为37.14。VNS植入后评分范围为31-72,平均评分为52.86。
VNS对癫痫患者的生活质量有显著影响。比较和评估PRE患者生活质量的最佳方法可能是QoLiE-31-P量表,该量表可在癫痫中心进行调整和使用,以评估精力、情绪、日常活动、认知、药物疗效、癫痫担忧和总体生活质量。