Vagus nerve stimulator implantation for epilepsy in a paediatric hospital: outcomes and effect on quality of life.

INTRODUCTION: Epilepsy, which is present in 0.5% to 1% of the paediatric population, is one of the most frequent childhood neurological disorders. Approximately 20% to 30% of these cases will be drug-resistant. The objective of this study is to describe the impact of vagal nerve stimulation (VNS) on seizures and quality of life in a sample of 30 patients. METHODS: Descriptive, retrospective study of all patients with a VNS device implanted between 2008 and 2013 in a single paediatric hospital, based on patients' medical records. Quality of life was assessed using the Spanish scale for quality of life in children with epilepsy, completed by means of a telephone interview. RESULTS: We describe a population of 19 boys (64%) and 11 girls (36%) with a mean age at seizure onset of 21 months (1-144 months). The mean age of VNS implantation was 11.89 years. Follow-up periods ranged from 6 to 36 months. Mean reduction in seizures at 6 months was 38%, with a reduction of 43% at 12 months, 42% at 24 months, and 54% at 36 months. At least half of all patients were classified as responders. According to the quality of life scale, 54% of the families rated the effect of VNS as either very good or good while 39% rated it as fair. CONCLUSIONS: VNS is a safe palliative treatment that is generally well tolerated. It is partially effective for controlling drug-resistant epilepsy and exerts a positive effect on quality of life.

Inhibition of phytohaemagglutinin-induced transformation of lymphocytes by human spleen extracts.

The presence in human spleen extracts of a substance capable of inhibiting the phytohaemagglutinin (PHA)-induced transformation of lymphocytes into lymphoblasts was demonstrated by analysing the nuclear size of cultured human lymphocytes. In this way the artefacts produced by the methods based on the uptake of 3H-thymidine were avoided. The inhibitor did not compete with PHA for the same membrane receptor-site, since adding the extract 24 h after the PHA-stimulation still produced a significant inhibition. The lack of cytotoxicity of the extract was demonstrated by the fact that cultures that lasted for six days, instead of three days, resulted in a pattern similar to that of control cultures. An attempt to partially purify the inhibitor by means of ammonium sulphate fractionation showed that the highest activity precipitated between 0.5 and 0.6 saturation although, due to the characteristics of the assay, it was difficult to assess the actual degree of purification.

[Study of an inhibitor of lymphocyte proliferation present in spleen extracts]. / Estudio de un inhibidor de la proliferación linfocítica presente en extractos de bazo.

The spleen factor inhibiting the lymphoblastic transformation after mitogenic stimulation was concentrated thirty times by chromatography of spleen extracts. The inhibiting factor has a molecular weight of 3,000 D.