Vagus nerve stimulation for control of intractable seizures in childhood

被引:15
作者
Amar, AP
Levy, ML
McComb, JG
Apuzzo, MLJ
机构
[1] Univ So Calif, Keck Sch Med, Dept Neurosurg, Los Angeles, CA USA
[2] Childrens Hosp, Div Neurosurg, Los Angeles, CA 90027 USA
关键词
children; epilepsy; pediatric; seizure; vagus nerve stimulation;
D O I
10.1159/000056023
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Vagus nerve stimulation (VNS) is gaining increasing popularity and credibility as a treatment option for children with intractable epilepsy, VNS offers several advantages over extant treatments. Its efficacy is maintained during prolonged stimulation, and seizure control actually improves with time. There is no associated cognitive impairment and no adverse drug interactions. Unlike cerebral surgery, VNS is a potentially reversible form of therapy. The computer-controlled characteristic of the device perm its complete and involuntary treatment compliance. VNS is safe and well-tolerated, Its side effects are generally transient and mild, and no physiologic perturbations have been reported despite extensive monitoring. Serious adverse events are rare, and no deaths have been attributed to VNS therapy itself or to the technique of surgical insertion. In this article, we discuss the theoretical background behind VNS and review the clinical studies that substantiate its long-term safety, feasibility, tolerabiiity and potential efficacy in children with refractory epilepsy.
引用
收藏
页码:218 / 223
页数:6
相关论文
共 17 条
[1]   An institutional experience with cervical vagus nerve trunk stimulation for medically refractory epilepsy: Rationale, technique, and outcome [J].
Amar, AP ;
Heck, CN ;
Levy, ML ;
Smith, T ;
DeGiorgio, CM ;
Oviedo, S ;
Apuzzo, MLJ .
NEUROSURGERY, 1998, 43 (06) :1265-1276
[2]   Long-term multicenter experience with vagus nerve stimulation for intractable partial seizures - Results of the XE5 trial [J].
Amar, AP ;
DeGiorgio, CM ;
Tarver, WB ;
Apuzzo, MLJ .
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, 1999, 73 (1-4) :104-108
[3]   Experience with vagus nerve stimulation for intractable epilepsy: Some questions and answers [J].
Amar, AP ;
Heck, CN ;
DeGiorgio, CM ;
Apuzzo, MLJ .
NEUROLOGIA MEDICO-CHIRURGICA, 1999, 39 (07) :489-495
[4]  
AMAR AP, IN PRESS YOUMANS TXB
[5]  
AMAR AP, 2000, NEUROSURGICAL OPERAT, V9, P79
[6]   Vagus nerve stimulation for medically refractory epilepsy; Efficacy and cost-benefit analysis [J].
Boon, P ;
Vonck, K ;
Vandekerckhove, T ;
D'have, M ;
Nieuwenhuis, L ;
Michielsen, G ;
Vanbelleghem, H ;
Goethals, I ;
Caemaert, J ;
Calliauw, L ;
De Reuck, J .
ACTA NEUROCHIRURGICA, 1999, 141 (05) :447-453
[7]  
DeGiorgio C.M., 2001, VAGUS NERVE STIMULAT, P31
[8]   Reassessment: Vagus nerve stimulation for epilepsy - A report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology [J].
Fisher, RS ;
Handforth, A .
NEUROLOGY, 1999, 53 (04) :666-669
[9]   Left vagus nerve stimulation in children with refractory epilepsy: An update [J].
Hornig, GW ;
Murphy, JV ;
Schallert, G ;
Tilton, C .
SOUTHERN MEDICAL JOURNAL, 1997, 90 (05) :484-488
[10]   Locus coeruleus lesions suppress the seizure-attenuating effects of vagus nerve stimulation [J].
Krahl, SE ;
Clark, KB ;
Smith, DC ;
Browning, RA .
EPILEPSIA, 1998, 39 (07) :709-714