Lundgren J, Amark P, Blennow G, Strömblad L G, Wallstedt L
Department of Pediatrics, University Hospital, Lund, Sweden.
Epilepsia. 1998 Aug;39(8):809-13. doi: 10.1111/j.1528-1157.1998.tb01173.x.
Vagus nerve stimulation (VNS) has been reported to produce >90% reduction in the number of seizures in children with intractable epilepsy. These encouraging results need confirmation.
Sixteen children, 10 boys and 6 girls aged 4-19 years, were treated with VNS (Cyberonics, Webster, TX, U.S.A.) for 12-24 months. Seizure frequency, seizure severity, changes in quality of life (QOL: visual analogue scale), and side effects were recorded. Eight children had partial and 8 had generalized seizures; 4 of the latter had Lennox-Gastaut syndrome (LGS).
During the tenth to twelfth month of VNS, 6 of 16 children experienced > or =50% reduction in seizure frequency. One girl became seizure-free. Seizure severity showed an average decrease in the score from 15 to 11. After 10 months of treatment, QOL was estimated to have improved > or =50% in 6 of 16 children. Reduction in seizure frequency, decreased seizure severity, and reported improvement in QOL did not entirely coincide. Six children experienced hoarseness, 1 had neck pain, 2 had hypersalivation, 2 experienced tiredness, 2 had aspiration episodes during liquid intake, and 6 had electrical transmission problems; in 4 the problem has been surgically corrected. Five stimulators were turned off due to lack of efficacy.
Six of 16 children with refractory epilepsy treated with VNS improved, with a reduction not only in seizure frequency but also in seizure severity and in QOL.
据报道，迷走神经刺激（VNS）可使难治性癫痫患儿的癫痫发作次数减少90%以上。这些令人鼓舞的结果需要得到证实。
16名儿童（10名男孩和6名女孩，年龄4 - 19岁）接受了VNS（美国德克萨斯州韦伯斯特市赛博onics公司生产）治疗，为期12 - 24个月。记录癫痫发作频率、发作严重程度、生活质量变化（QOL：视觉模拟量表）及副作用。8名儿童为部分性发作，8名儿童为全身性发作；后者中有4名患有伦诺克斯 - 加斯东综合征（LGS）。
在VNS治疗的第10至12个月期间，16名儿童中有6名癫痫发作频率降低了≥50%。1名女孩癫痫发作停止。发作严重程度评分平均从15分降至11分。治疗10个月后，16名儿童中有6名的生活质量估计改善了≥50%。癫痫发作频率降低、发作严重程度减轻以及生活质量改善的报告并不完全一致。6名儿童出现声音嘶哑，1名儿童有颈部疼痛，2名儿童流涎过多，2名儿童感到疲倦，2名儿童在饮水时出现误吸情况，6名儿童存在电传输问题；其中4名儿童的问题已通过手术矫正。5个刺激器因无效而关闭。
16名接受VNS治疗的难治性癫痫儿童中有6名病情得到改善，不仅癫痫发作频率降低，发作严重程度和生活质量也有所改善。
