Concurrent brain-responsive and vagus nerve stimulation for treatment of drug-resistant focal epilepsy.
Epilepsy Behav
; 129: 108653, 2022 04.
Article
em En
| MEDLINE
| ID: mdl-35305525
ABSTRACT
OBJECTIVE:
Clinical trials of a brain-responsive neurostimulator, RNS® System (RNS), excluded patients with a vagus nerve stimulator, VNS® System (VNS). The goal of this study was to evaluate seizure outcomes and safety of concurrent RNS and VNS stimulation in adults with drug-resistant focal-onset seizures.METHODS:
A retrospective multicenter chart review was performed on all patients with an active VNS and RNS who were treated for a minimum of 6â¯months with both systems concurrently. Frequency of disabling seizures at baseline before RNS, at 1â¯year after RNS placement, and at last follow-up were used to calculate the change in seizure frequency after treatment. Data on adverse events and complications related to each device were collected.RESULTS:
Sixty-four patients from 10 epilepsy centers met inclusion criteria. All but one patient received RNS after VNS. The median follow-up time after RNS implantation was 28â¯months. Analysis of the entire population of patients with active VNS and RNS systems revealed a median reduction in seizure frequency at 1â¯year post-RNS placement of 43% with a responder rate of 49%, and at last follow-up a 64% median reduction with a 67% responder rate. No negative interactions were reported from the concurrent use of VNS and RNS. Stimulation-related side-effects were reported more frequently in association with VNS (30%) than with RNS (2%).SIGNIFICANCE:
Our findings suggest that concurrent treatment with VNS and RNS is safe and that the addition of RNS to VNS can further reduce seizure frequency.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Epilepsias Parciais
/
Estimulação do Nervo Vago
/
Epilepsia Resistente a Medicamentos
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Epilepsy Behav
Assunto da revista:
CIENCIAS DO COMPORTAMENTO
/
NEUROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos