Scholarlink

For patients who are not eligible for epilepsy surgery or for whom surgical procedures have been unsuccessful, neurostimulation can be considered as an alternative option. Neurostimulation is defined as the delivery of electrical, magnetic, or ultrasound energy to the nervous system, with the aim of alleviating neurological symptoms. For these individuals, neurostimulation strategies, such as vagus nerve stimulation (VNS), have emerged as promising adjuncts or alternatives (Englot DJ, et al., J Neurosurg 115(6):1248–1255, 2011; Chrastina J, et al., Child’s Nerv Syst 39(11):3215–3224, 2023) Reports also exist of VNS being successfully utilized in patients with drug-resistant and super-drug-resistant status epilepticus (Jha R, et al., Epilepsia Open 9(3):850–864, 2024; Stavropoulos I, et al., Front Neurol 14(3):1–12, 2023). Among the various forms of seizures, drop attacks pose significant challenges in the management of epilepsy due to their sudden onset, the risk of severe injury they engender, and their resistance to medical treatment (Manford E, et al., Pract Neurol 24(2):106–113, 2023; Tinuper P, et al., J Neurol Neurosurg Psychiatry 64(2):231–237, 1998). Patients affected by this type of seizure may be required to wear helmets, and environmental modifications are regularly used to reduce the risk of injury from falls. When pharmacological interventions fail, corpus callosotomy (CC)—the primary neurosurgical treatment for Lennox Gastaut syndrome (LGS) (Roth J, et al., Epilepsia 64(12):3205–3212, 2023)−and VNS emerge as potential solutions. Both techniques aim to mitigate the frequency and severity of seizures, yet they differ fundamentally in mechanism, invasiveness, and long-term outcomes. There are controversies surrounding the use of VNS and CC for drop attacks, comparing their efficacy, safety, and impact on quality of life (Rolston JD, et al., Epilepsy Behav 51:13–17, 2015; Zamponi N, et al., Seizure 20(6):468–474, 2011). Among the alternative neuromodulation techniques for DRE are deep brain stimulation (DBS) of the anterior nucleus of the thalamus and responsive neurostimulation; the latter is currently unavailable in the EU.

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

Vagus Nerve Stimulation for the Management of Epilepsy and Epileptic Drop Attacks

  • 章节

  • 发表日期：

    2026年

查看全文
  • Kristl Vonck,
  • Chiara Silvestri,
  • Paul Boon

摘要

For patients who are not eligible for epilepsy surgery or for whom surgical procedures have been unsuccessful, neurostimulation can be considered as an alternative option. Neurostimulation is defined as the delivery of electrical, magnetic, or ultrasound energy to the nervous system, with the aim of alleviating neurological symptoms. For these individuals, neurostimulation strategies, such as vagus nerve stimulation (VNS), have emerged as promising adjuncts or alternatives (Englot DJ, et al., J Neurosurg 115(6):1248–1255, 2011; Chrastina J, et al., Child’s Nerv Syst 39(11):3215–3224, 2023) Reports also exist of VNS being successfully utilized in patients with drug-resistant and super-drug-resistant status epilepticus (Jha R, et al., Epilepsia Open 9(3):850–864, 2024; Stavropoulos I, et al., Front Neurol 14(3):1–12, 2023). Among the various forms of seizures, drop attacks pose significant challenges in the management of epilepsy due to their sudden onset, the risk of severe injury they engender, and their resistance to medical treatment (Manford E, et al., Pract Neurol 24(2):106–113, 2023; Tinuper P, et al., J Neurol Neurosurg Psychiatry 64(2):231–237, 1998). Patients affected by this type of seizure may be required to wear helmets, and environmental modifications are regularly used to reduce the risk of injury from falls. When pharmacological interventions fail, corpus callosotomy (CC)—the primary neurosurgical treatment for Lennox Gastaut syndrome (LGS) (Roth J, et al., Epilepsia 64(12):3205–3212, 2023)−and VNS emerge as potential solutions. Both techniques aim to mitigate the frequency and severity of seizures, yet they differ fundamentally in mechanism, invasiveness, and long-term outcomes. There are controversies surrounding the use of VNS and CC for drop attacks, comparing their efficacy, safety, and impact on quality of life (Rolston JD, et al., Epilepsy Behav 51:13–17, 2015; Zamponi N, et al., Seizure 20(6):468–474, 2011). Among the alternative neuromodulation techniques for DRE are deep brain stimulation (DBS) of the anterior nucleus of the thalamus and responsive neurostimulation; the latter is currently unavailable in the EU.