Article
Outpatient Vagus Nerve Stimulator For Medically Intractable Epilepsy: Indication and results
Ambulante Implantation von N.-Vagus-Stimulatoren bei Kindern mit therapieresistenter Epilepsie
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Published: | April 23, 2004 |
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Outline
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Objective
Vagus nerve stimulation has gained increasing importance for the treatment of medically intractable epilepsy in children. We report our indications, surgical management and results in 21 patients.
Methods
Between June 2001 and August 2003, a vagus nerve stimulator was implanted in 21 children (11 male, 10 female). The age at the time of surgery was 7 to 17 years (mean 12 years). The follow-up ranges between 3 months and 24 months (mean 18 months). The indication for surgery was given in pediatric patients with medically intractable epilepsy. Eight surgeries were performed as inpatient surgeries with a one day stay in hospital. Thirteen procedures were performed as ambulatory surgery with discharge of the patients 4-6 hours after surgery.
Results
Nine patients improved significantly following the procedure. Five patients improved insignificantly, and seven patients remained in the same status as they were pre-operatively. Improvement was measured by seizure frequency and intensity, EEG patterns, reduction of oral medication intake and positive psycho-social and cognitive development. One patient required a surgical wound revision (inpatient). No further complications occurred. There were no differences with regard to the outcome or complications between the two patient groups (inpatient, outpatient).
Conclusions
Vagus nerve stimulator is a safe and effective measure for pediatric patients with therapy-resistant epilepsy. It can safely be performed as an outpatient procedure.