Scholarlink

Purpose <p>To evaluate the long-term efficacy of vagus nerve stimulation (VNS) in reducing tonic-clonic seizures (TCS), drop attacks, and seizure clusters in adults with drug-resistant epilepsy (DRE).</p> Methods <p>This retrospective, single-center study included adults with DRE who received VNS and had ≥ 12 months of follow-up. Data were collected pre-implantation (T0), at 12 months (T1), and last follow-up (T2). Outcomes included reduction in total seizure frequency and severity, frequency of TCS and drop attacks, and frequency/duration of seizure clusters. Battery replacement and tolerability were also assessed.</p> Results <p>Eighty-seven subjects (51 males, median age 33 at T0) with a mean follow-up of 8 years were analyzed. At T2, 54% showed reduced total seizure frequency and 71% reported decreased severity/duration. Among those with baseline TCS, 75% (T1)–80.6% (T2) had frequency reduction, with 20.6% seizure-free at T2. Drop attacks improved in &gt; 70% of cases, with resolution in 21.8% at T2. Over 80% with seizure clusters reported decreased frequency/duration at both T1 and T2. Response rates for specific seizure types significantly exceeded non-response (<i>p</i> &lt; 0.001). Battery replacement was required in 85.7% near depletion. Side effects occurred in 49.4%, mostly mild/transient; major complications were rare.</p> Conclusion <p>VNS exerts a robust effect on the most disabling seizures—TCS, drop attacks, and seizure clusters—surpassing its impact on overall seizure burden. Benefits appear within the first year and persist long term. These findings support a more tailored approach to VNS candidate selection, advocating earlier use in patients with refractory, harmful seizures not eligible for curative surgery.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The impact of vagus nerve stimulation on the most disabling seizures: A retrospective study in adults with drug-resistant epilepsy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月10日

查看全文
  • Anna Scarabello,
  • Luca Zanuttini,
  • Martino Schettino,
  • Lorenzo Muccioli,
  • Lorenzo Ferri,
  • Francesca Bisulli,
  • Ilaria Naldi,
  • Lilia Volpi,
  • Roberto Michelucci,
  • Antonella Boni,
  • Valentina Gentile,
  • Mino Zucchelli,
  • Paolo Tinuper,
  • Matteo Martinoni,
  • Barbara Mostacci

摘要

Purpose

To evaluate the long-term efficacy of vagus nerve stimulation (VNS) in reducing tonic-clonic seizures (TCS), drop attacks, and seizure clusters in adults with drug-resistant epilepsy (DRE).

Methods

This retrospective, single-center study included adults with DRE who received VNS and had ≥ 12 months of follow-up. Data were collected pre-implantation (T0), at 12 months (T1), and last follow-up (T2). Outcomes included reduction in total seizure frequency and severity, frequency of TCS and drop attacks, and frequency/duration of seizure clusters. Battery replacement and tolerability were also assessed.

Results

Eighty-seven subjects (51 males, median age 33 at T0) with a mean follow-up of 8 years were analyzed. At T2, 54% showed reduced total seizure frequency and 71% reported decreased severity/duration. Among those with baseline TCS, 75% (T1)–80.6% (T2) had frequency reduction, with 20.6% seizure-free at T2. Drop attacks improved in > 70% of cases, with resolution in 21.8% at T2. Over 80% with seizure clusters reported decreased frequency/duration at both T1 and T2. Response rates for specific seizure types significantly exceeded non-response (p < 0.001). Battery replacement was required in 85.7% near depletion. Side effects occurred in 49.4%, mostly mild/transient; major complications were rare.

Conclusion

VNS exerts a robust effect on the most disabling seizures—TCS, drop attacks, and seizure clusters—surpassing its impact on overall seizure burden. Benefits appear within the first year and persist long term. These findings support a more tailored approach to VNS candidate selection, advocating earlier use in patients with refractory, harmful seizures not eligible for curative surgery.