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迷走神经刺激在耐药性癫痫治疗中的作用:临床疗效和对生活质量的影响。

The role of vagus nerve stimulation in the treatment of refractory epilepsy: Clinical outcomes and impact on quality of life.

机构信息

Servicio de Neurocirugía, Hospital General Universitario de Alicante, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Alicante, España.

Servicio de Neurocirugía, Hospital General Universitario de Alicante, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Alicante, España.

出版信息

Neurologia (Engl Ed). 2022 Jul-Aug;37(6):450-458. doi: 10.1016/j.nrl.2019.04.002. Epub 2019 Jul 22.

Abstract

BACKGROUND

Vagus nerve stimulation (VNS) is used as a complementary therapy to pharmacological treatment in patients with refractory epilepsy. This study aims to evaluate the efficacy of VNS in reducing seizure frequency, severity, and duration; reducing the number of antiepileptic drugs administered; and improving patients' quality of life.

MATERIAL AND METHODS

We analysed the clinical progression of 70 patients with refractory epilepsy treated with VNS at Hospital Universitario de Alicante and Hospital Clínico de Valencia. Data were collected before and after the procedure. The difference in seizure frequency pre- and post-VNS was classified using the McHugh scale. Data were also collected on seizure duration and severity, the number of drugs administered, and quality of life.

RESULTS

According to the McHugh classification, 12.86% of the patients were Class I, 44.29% were Class II, 40% were Class III, and the remaining 2.86% of patients were Class IV-V. A≥50% reduction in seizure frequency was observed in 57.15% of patients. Improvements were observed in seizure duration in 88% of patients and in seizure severity in 68%; the number of drugs administered was reduced in 66% of patients, and 93% reported better quality of life.

CONCLUSIONS

VNS is effective for reducing seizure frequency, duration, and severity and the number of antiepileptic drugs administered. It also enables an improvement in patients' quality of life.

摘要

背景

迷走神经刺激(VNS)被用作难治性癫痫患者药物治疗的补充疗法。本研究旨在评估 VNS 降低癫痫发作频率、严重程度和持续时间、减少抗癫痫药物使用数量以及改善患者生活质量的疗效。

材料与方法

我们分析了在阿利坎特大学医院和瓦伦西亚临床医院接受 VNS 治疗的 70 例难治性癫痫患者的临床进展情况。在手术前后收集数据。使用 McHugh 量表对 VNS 前后癫痫发作频率的差异进行分类。还收集了癫痫发作持续时间和严重程度、药物使用数量和生活质量的数据。

结果

根据 McHugh 分类,12.86%的患者为 I 级,44.29%为 II 级,40%为 III 级,其余 2.86%为 IV-V 级。57.15%的患者癫痫发作频率降低≥50%。88%的患者癫痫持续时间改善,68%的患者癫痫严重程度改善;66%的患者减少了药物使用数量,93%的患者报告生活质量改善。

结论

VNS 可有效降低癫痫发作频率、持续时间和严重程度以及抗癫痫药物的使用数量,并改善患者的生活质量。

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