The preliminary analysis of clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy in children_Journal of Epilepsy

Authors：

WANG Zhongming ^1,2 , WANG Qin ¹ , PENG Qiong ¹ , HUANG Yahui ¹ , LI Zhenguang ¹ , CHEN Pan ¹ ,  LU Jun ^1,2

1. Epilepsy Center, Hunan Brain Hospital, the Second People’s Hospital of Hunan Province, Changsha 410073, China;
2. Clinical School of Medicine, Hunan University of Chinese Medicine, Changsha 410073, China;

Corresponding author：

LU Jun, Email: 53558059@qq.com

Keywords：

Vagus nerve stimulation; Children; Refractory epilepsy; Surgical treatment

DOI：

10.7507/2096-0247.202406011

Video：

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Objective To investigate the efficacy of vagus nerve stimulation (VNS) in the treatment of refractory epilepsy in children and the key factors affecting its efficacy. Methods The clinical data of 22 children with drug-resistant epilepsy who received VNS treatment in the Second People's Hospital of Hunan Province from January 2016 to April 2023 were analyzed. The average seizure reduction rate, effective rate and McHugh grade were used to evaluate the efficacy of VNS after at least 1 year follow-up. Patients with an attack reduction rate of ≥50% were defined as respondents, and Mann-Witney U test and χ² test were used, respectively, to conduct univariate and multifactor Logistics regression analysis with statistically significant indicators (P<0.05). Results Among the 22 patients, the average attack reduction rate was 12.66% at 1 month, 26.10% at 3 months, 37.47% at 6 months, 48.18% at 9 months and 54.38% at 12 months. The effective rate was 5.00%, 9.00%, 36.00%, 50.00% and 68.00%, respectively. 12 months after operation, there were 3 cases of grade I, 12 cases of grade II, 7 cases of grade III, and 0 cases of grade V. Unifactorial and multivariate Logistic regression analysis showed that the curative effect of epilepsy in children was related to the seizure type, among which the curative effect of general seizure was better than that of focal seizure (OR=0.062, P=0.014), and the curative effect of myoclonic seizure and tonic seizure was better than that of other types in general seizure. Conclusion The clinical effect of VNS in the treatment of refractory epilepsy in children is time cumulative, and the surgical effect of myoclonic seizures and tonic seizures in general seizures is better.

Citation： WANG Zhongming, WANG Qin, PENG Qiong, HUANG Yahui, LI Zhenguang, CHEN Pan, LU Jun. The preliminary analysis of clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy in children. Journal of Epilepsy, 2024, 10(5): 398-403. doi: 10.7507/2096-0247.202406011 Copy

1.	王薇薇, 吴逊. 脑网络理论在癫痫临床中的意义及应用. 癫痫杂志, 2024, 10(1): 66-72.
2.	许子骜. 通过DTI分析丘脑-皮层结构连接与药物难治性癫痫患者行迷走神经刺激术疗效的关系. 安徽医科大学, 2023, 硕士学位论文.
3.	顾锐, 纪凡, 朱晋. 迷走神经刺激术治疗儿童癫痫的疗效预测因素分析. 临床神经外科杂志, 2022, 19(5): 488-491,496.
4.	周晶晶, 贾圣陶, 张晓华, 等. 迷走神经刺激术治疗5例难治性抑郁症患者的疗效及安全性分析. 神经疾病与精神卫生, 2022, 22(3): 172-176.
5.	郭永坤, 赵德枭, 刘春颖, 等. 迷走神经刺激术治疗药物难治性癫痫. 中华神经创伤外科电子杂志, 2021, 7(6): 383-384.
6.	谭泊静, 李云林, 马康平, 等. 迷走神经刺激术治疗SCN1A基因异常相关儿童难治性癫痫5例并文献复习. 立体定向和功能性神经外科杂志, 2021, 34(3): 141-144.
7.	曾媛香, 胡越. 迷走神经刺激术治疗儿童难治性癫痫的研究进展. 癫痫杂志, 2021, 7(1): 49-53.
8.	Fang JJ, Shan W, Wu JP, et al. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neuroscience & Therapeutics, 2019, 25(11): 1222-1228.
9.	张桐, 汤继宏. 迷走神经刺激术治疗儿童药物难治性癫痫的研究进展. 癫痫杂志, 2019, 5(6): 463-466.
10.	曾媛香. 迷走神经刺激术治疗儿童药物难治性癫痫的有效性及安全性分析. 重庆医科大学, 2021, 硕士学位论文.
11.	Tufo T , Izzo A , Fuggetta M , et al. Retrospective open-label study of efficacy and tolerability of vagus nerve stimulation (VNS) for treatment of drug-resistant epilepsy: long-term follow up. Journal of the Neurological Sciences, 2019, 405 (Suppl): 121-121.
12.	向迅捷, 孙留中, 徐才邦, 等. 迷走神经电刺激术治疗难治性癫痫的临床疗效观察. 广西医学, 2019, 41(14): 1843-1845.
13.	Alja K , Nina K , Zvonka R , et al. Efficacy and tolerability of vagus nerve stimulation therapy (VNS) in Slovenian epilepsy patients: younger age and shorter duration of epilepsy might result in better outcome. Acta clinica Croatica, 2019, 58(2): 255-264.
14.	González FH , Yengo-Kahn A , Englot JD . Vagus nerve stimulation for the treatment of epilepsy . Neurosurgery Clinics of North America, 2019, 30 (2): 219-230.
15.	王娴, 李莉萍, 遇涛, 等. 植入式迷走神经刺激治疗难治性癫痫的有效性分析. 中华神经科杂志, 2018, 51(10): 819-823.
16.	李潇啸, 孙涛, 刘阳, 等. 迷走神经刺激术在儿童药物难治性癫痫中的应用. 宁夏医科大学学报, 2018, 40(3): 323-326.
17.	方铁, 方方, 张杰, 等. 迷走神经刺激治疗儿童难治性癫痫的初步疗效分析. 中华神经外科疾病研究杂志, 2017, 16(5): 407-411.

1. 王薇薇, 吴逊. 脑网络理论在癫痫临床中的意义及应用. 癫痫杂志, 2024, 10(1): 66-72.
2. 许子骜. 通过DTI分析丘脑-皮层结构连接与药物难治性癫痫患者行迷走神经刺激术疗效的关系. 安徽医科大学, 2023, 硕士学位论文.
3. 顾锐, 纪凡, 朱晋. 迷走神经刺激术治疗儿童癫痫的疗效预测因素分析. 临床神经外科杂志, 2022, 19(5): 488-491,496.
4. 周晶晶, 贾圣陶, 张晓华, 等. 迷走神经刺激术治疗5例难治性抑郁症患者的疗效及安全性分析. 神经疾病与精神卫生, 2022, 22(3): 172-176.
5. 郭永坤, 赵德枭, 刘春颖, 等. 迷走神经刺激术治疗药物难治性癫痫. 中华神经创伤外科电子杂志, 2021, 7(6): 383-384.
6. 谭泊静, 李云林, 马康平, 等. 迷走神经刺激术治疗SCN1A基因异常相关儿童难治性癫痫5例并文献复习. 立体定向和功能性神经外科杂志, 2021, 34(3): 141-144.
7. 曾媛香, 胡越. 迷走神经刺激术治疗儿童难治性癫痫的研究进展. 癫痫杂志, 2021, 7(1): 49-53.
8. Fang JJ, Shan W, Wu JP, et al. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neuroscience & Therapeutics, 2019, 25(11): 1222-1228.
9. 张桐, 汤继宏. 迷走神经刺激术治疗儿童药物难治性癫痫的研究进展. 癫痫杂志, 2019, 5(6): 463-466.
10. 曾媛香. 迷走神经刺激术治疗儿童药物难治性癫痫的有效性及安全性分析. 重庆医科大学, 2021, 硕士学位论文.
11. Tufo T , Izzo A , Fuggetta M , et al. Retrospective open-label study of efficacy and tolerability of vagus nerve stimulation (VNS) for treatment of drug-resistant epilepsy: long-term follow up. Journal of the Neurological Sciences, 2019, 405 (Suppl): 121-121.
12. 向迅捷, 孙留中, 徐才邦, 等. 迷走神经电刺激术治疗难治性癫痫的临床疗效观察. 广西医学, 2019, 41(14): 1843-1845.
13. Alja K , Nina K , Zvonka R , et al. Efficacy and tolerability of vagus nerve stimulation therapy (VNS) in Slovenian epilepsy patients: younger age and shorter duration of epilepsy might result in better outcome. Acta clinica Croatica, 2019, 58(2): 255-264.
14. González FH , Yengo-Kahn A , Englot JD . Vagus nerve stimulation for the treatment of epilepsy . Neurosurgery Clinics of North America, 2019, 30 (2): 219-230.
15. 王娴, 李莉萍, 遇涛, 等. 植入式迷走神经刺激治疗难治性癫痫的有效性分析. 中华神经科杂志, 2018, 51(10): 819-823.
16. 李潇啸, 孙涛, 刘阳, 等. 迷走神经刺激术在儿童药物难治性癫痫中的应用. 宁夏医科大学学报, 2018, 40(3): 323-326.
17. 方铁, 方方, 张杰, 等. 迷走神经刺激治疗儿童难治性癫痫的初步疗效分析. 中华神经外科疾病研究杂志, 2017, 16(5): 407-411.

Journal of Epilepsy

The preliminary analysis of clinical effect of vagus nerve stimulation in the treatment of refractory epilepsy in children

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