Santi Samuele, Fuggetta Filomena, Colicchio Gabriella, D'Ercole Manuela, Izzo Alessandro, D'Alessandris Quintino Giorgio, Burattini Benedetta, Martinelli Renata, Montano Nicola
Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Brain Sci. 2024 Jun 26;14(7):639. doi: 10.3390/brainsci14070639.
Epilepsy treatment primarily involves antiseizure medications (ASMs) to eliminate seizures and improve the quality of life, but many patients develop drug-resistant epilepsy (DRE), necessitating alternative interventions. This study aimed to evaluate the long-term efficacy and safety of vagus nerve stimulation (VNS) in managing DRE. We retrospectively analyzed data from 105 adult patients treated at Agostino Gemelli Hospital from 1994 to 2022. Among the 73 patients with follow-up data, 80.8% were responders, experiencing significant reductions in seizure frequency over an average follow-up period of 9.4 years. Although 19.2% were non-responders, many of these patients still opted for generator replacements due to improvements in quality of life, such as fewer falls and shorter post-ictal periods. The overall complication rate was 12.3%, with most complications being mild and manageable. These findings suggest that VNS offers substantial long-term benefits for patients with DRE, improving seizure control and quality of life. This study underscores the importance of VNS as a viable long-term treatment option for DRE, highlighting its potential to significantly enhance patient outcomes and quality of life.
癫痫治疗主要涉及使用抗癫痫药物(ASMs)来消除癫痫发作并改善生活质量,但许多患者会发展为药物难治性癫痫(DRE),因此需要采取替代干预措施。本研究旨在评估迷走神经刺激(VNS)治疗DRE的长期疗效和安全性。我们回顾性分析了1994年至2022年在阿戈斯蒂诺·杰梅利医院接受治疗的105例成年患者的数据。在有随访数据的73例患者中,80.8%为有反应者,在平均9.4年的随访期内癫痫发作频率显著降低。虽然19.2%为无反应者,但这些患者中的许多人仍因生活质量的改善(如跌倒次数减少和发作后时期缩短)而选择更换发生器。总体并发症发生率为12.3%,大多数并发症为轻度且可控。这些发现表明,VNS为DRE患者带来了显著的长期益处,改善了癫痫控制和生活质量。本研究强调了VNS作为DRE可行的长期治疗选择的重要性,突出了其显著提高患者治疗效果和生活质量的潜力。