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癫痫中的迷走神经刺激:认知缺陷参与者的经历

Vagal Nerve Stimulation in Epilepsy: Experiences of Participants with Cognitive Deficits.

作者信息

Pipan Eva, Apostolou Alexandros, Bograkou Maria, Brooks Petra, Vigren Patrick, Gauffin Helena

机构信息

University Medical Centre Ljubljana, Ljubljana, Slovenia.

Department of Neurology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

出版信息

Neuropsychiatr Dis Treat. 2020 May 8;16:1181-1188. doi: 10.2147/NDT.S241716. eCollection 2020.

Abstract

INTRODUCTION

The purpose of this study was to examine patients' experiences of vagal nerve stimulation (VNS) with a special interest in patients with cognitive deficit (CD).

MATERIALS AND METHODS

An open, retrospective study was conducted on 82 patients with pharmacoresistant epilepsy, who were treated with VNS for at least 10 months. Based on the inability to live independently, they were divided into two groups: patients with cognitive deficit (CD group) and patients without cognitive deficit (non-CD group). A specially designed questionnaire was used for semi-structured interviews about patients' experiences of VNS treatment.

RESULTS

Approximately one-third described a continuous reduction of seizure frequency of 50% or more and were regarded as responders. Fewer subjects in the CD group were responders than in the non-CD group. Approximately one-third of all subjects had no positive effect of VNS treatment. More CD patients described additional improvements and the most common were milder seizures and improved alertness. The most commonly reported adverse effect was hoarseness.

DISCUSSION

VNS treatment in patients without CD had better effect on seizure frequency reduction than in patients with CD, but many patients with CD reported other benefits from the treatment.

CONCLUSION

Non-CD patients had higher seizure frequency reduction than CD patients during VNS treatment, but many CD patients described other benefits.

摘要

引言

本研究旨在调查患者接受迷走神经刺激(VNS)治疗的体验,尤其关注认知缺陷(CD)患者的体验。

材料与方法

对82例药物难治性癫痫患者进行了一项开放性回顾性研究,这些患者接受VNS治疗至少10个月。根据是否能够独立生活,将他们分为两组:认知缺陷患者(CD组)和无认知缺陷患者(非CD组)。使用一份专门设计的问卷对患者进行关于VNS治疗体验的半结构化访谈。

结果

约三分之一的患者称癫痫发作频率持续降低50%或更多,被视为治疗有效者。CD组中治疗有效的患者比非CD组少。所有受试者中约三分之一的人VNS治疗没有产生积极效果。更多的CD患者描述了其他改善情况,最常见的是发作减轻和警觉性提高。最常报告的不良反应是声音嘶哑。

讨论

无CD患者接受VNS治疗在降低癫痫发作频率方面比CD患者效果更好,但许多CD患者报告称该治疗有其他益处。

结论

VNS治疗期间,非CD患者癫痫发作频率降低程度高于CD患者,但许多CD患者描述了其他益处。

相似文献

本文引用的文献

1
Vagus nerve stimulation (VNS) therapy update.迷走神经刺激(VNS)疗法的最新进展。
Epilepsy Behav. 2018 Nov;88S:2-10. doi: 10.1016/j.yebeh.2018.06.032. Epub 2018 Jul 13.
3
Vagus Nerve Stimulation in children: A focus on intellectual disability.
Eur J Paediatr Neurol. 2017 May;21(3):427-440. doi: 10.1016/j.ejpn.2017.01.011. Epub 2017 Jan 30.
10
Consensus guidelines into the management of epilepsy in adults with an intellectual disability.成人伴智力障碍癫痫管理共识指南。
J Intellect Disabil Res. 2009 Aug;53(8):687-94. doi: 10.1111/j.1365-2788.2009.01182.x. Epub 2009 Jun 12.

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