Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
Neurology, Southmead Hospital, Bristol, UK.
Pract Neurol. 2020 May;20(3):189-198. doi: 10.1136/practneurol-2019-002210. Epub 2019 Dec 31.
Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%-40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.
迷走神经刺激（VNS）是一种用于治疗耐药性癫痫的神经调节治疗选择。在随机对照试验中，VNS 植入术在 1 年内使 26％-40％的患者的癫痫发作频率降低了 50％以上。长期的非对照研究表明，随着时间的推移，VNS 的反应会更好；但是，对其他潜在预测因素的评估导致了相互矛盾的结果。尽管最初设计用于治疗局灶性癫痫发作，但已将其用途扩展到其他形式的耐药性癫痫。在这篇综述中，我们讨论了支持使用 VNS 的证据，它对癫痫发作频率和生活质量的影响，以及这种治疗的常见不良反应。我们还包括了对有 VNS 患者的治疗方法和管理的实用指导。
