The efficacy and tolerability of auto-stimulation-VNS in children with Lennox-Gastaut syndrome
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVE: Lennox-Gastaut syndrome (LGS) is a severe drug-resistant epilepsy (DRE) of childhood. The Vagus Nerve Stimulator (VNS) is established as a safe and effective treatment for DRE. This study assesses efficacy and tolerability of the auto-stimulation VNS models in pediatric patients with LGS.
METHODS: This is a retrospective chart review of a cohort of pediatric patients (Age 1-18 years old) with LGS implanted with an auto-stimulation VNS model at a single level four pediatric epilepsy center. Patient responder's rate was measured as seizure reduction over baseline and improvements in five quality-of-life measures as reported by the patients and families. Efficacy and tolerability were assessed at 1, 3, 6, 12, 18 and 24 months compared to baseline.
RESULTS: This cohort includes 71 consecutive children with Lennox-Gastaut syndrome who underwent implantation with one of two models of the auto-stimulation VNS. The average age of the children at implantation was 20.82 months. Of those patients, 55 % of patients achieved greater than 50 % seizure reduction at six months, 67.7 % at 12 months, and 65 % at 24 months. At 12 months 11 % of the patients were completely seizure free and at 24 months 17 % were seizure free. By 24 months post implantation most of the patient families reported at least a 50 % improvement rate in one or more of the quality-of-life measures. The most commonly reported adverse events were dysphonia, paresthesia, and shortness of breath, all of which were tolerated and subsided by 24 months.
SIGNIFICANCE: This study provides evidence that VNS models with the auto-stimulation paradigm based on detection of tachycardia are well tolerated and effective in a pediatric population with LGS. Furthermore, this study shows that for this population, the auto-stimulation models of the VNS may provide additional benefits over the earlier VNS versions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:86 |
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| Enthalten in: |
Seizure - 86(2021) vom: 01. März, Seite 168-174 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Abdelmoity, Sherouk A [VerfasserIn] |
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| Links: |
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| Themen: |
Autostimulation |
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| Anmerkungen: |
Date Completed 12.07.2021 Date Revised 12.07.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.seizure.2021.02.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321847261 |
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| 100 | 1 | |a Abdelmoity, Sherouk A |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The efficacy and tolerability of auto-stimulation-VNS in children with Lennox-Gastaut syndrome |
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| 500 | |a Date Completed 12.07.2021 | ||
| 500 | |a Date Revised 12.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVE: Lennox-Gastaut syndrome (LGS) is a severe drug-resistant epilepsy (DRE) of childhood. The Vagus Nerve Stimulator (VNS) is established as a safe and effective treatment for DRE. This study assesses efficacy and tolerability of the auto-stimulation VNS models in pediatric patients with LGS | ||
| 520 | |a METHODS: This is a retrospective chart review of a cohort of pediatric patients (Age 1-18 years old) with LGS implanted with an auto-stimulation VNS model at a single level four pediatric epilepsy center. Patient responder's rate was measured as seizure reduction over baseline and improvements in five quality-of-life measures as reported by the patients and families. Efficacy and tolerability were assessed at 1, 3, 6, 12, 18 and 24 months compared to baseline | ||
| 520 | |a RESULTS: This cohort includes 71 consecutive children with Lennox-Gastaut syndrome who underwent implantation with one of two models of the auto-stimulation VNS. The average age of the children at implantation was 20.82 months. Of those patients, 55 % of patients achieved greater than 50 % seizure reduction at six months, 67.7 % at 12 months, and 65 % at 24 months. At 12 months 11 % of the patients were completely seizure free and at 24 months 17 % were seizure free. By 24 months post implantation most of the patient families reported at least a 50 % improvement rate in one or more of the quality-of-life measures. The most commonly reported adverse events were dysphonia, paresthesia, and shortness of breath, all of which were tolerated and subsided by 24 months | ||
| 520 | |a SIGNIFICANCE: This study provides evidence that VNS models with the auto-stimulation paradigm based on detection of tachycardia are well tolerated and effective in a pediatric population with LGS. Furthermore, this study shows that for this population, the auto-stimulation models of the VNS may provide additional benefits over the earlier VNS versions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Autostimulation | |
| 650 | 4 | |a Drug resistant epilepsy | |
| 650 | 4 | |a Epilepsy surgery | |
| 650 | 4 | |a Neuromodulation | |
| 650 | 4 | |a Pediatric epilepsy | |
| 700 | 1 | |a Abdelmoity, Ayman A |e verfasserin |4 aut | |
| 700 | 1 | |a Riordan, Sean M |e verfasserin |4 aut | |
| 700 | 1 | |a Kaufman, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Le Pichon, Jean-Baptiste |e verfasserin |4 aut | |
| 700 | 1 | |a Abdelmoity, Ahmed |e verfasserin |4 aut | |
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