Skip to main content
Log in

Vagus nerve stimulation in pediatric patients with failed epilepsy surgery

  • Original article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

Adequate control of pharmacoresistant epilepsy continues to be a challenge. Multiple studies have reported the benefits of epilepsy surgery and vagus nerve stimulation for children with pharmacoresistant epilepsy. Little is known about the role of vagus nerve stimulation for children with failed epilepsy surgeries. The aim of this study was to examine the effects of vagus nerve stimulation on seizure frequency reduction for children with failed epilepsy surgeries. We retrospectively reviewed 85 children with pharmacoresistant epilepsy who underwent vagus nerve stimulation. Six of these patients underwent epilepsy surgery before vagus nerve stimulation (group I) and 79 patients received only vagus nerve stimulation (group II). We recorded seizure frequency at 3, 12, 24 and 36 months after vagus nerve stimulator implantation. Both groups had reduced seizure frequencies at the 3-, 12-, 24- and 36-month follow-up (p = 0.044 for group I trends and 0.008 for group II trends). Vagus nerve stimulator implantations significantly improve seizure frequency for children with or without previous epilepsy surgery at 3, 12, 24 and 36 months. These findings suggest that vagus nerve stimulation should be considered an alternative therapy for pediatric patients with previous failed surgeries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Wiebe S (2004) Effectiveness and safety of epilepsy surgery: what is the evidence? CNS Spectr 9(120–2):126–132

    Google Scholar 

  2. Vakharia VN, Duncan JS, Witt J-A, Elger CE, Staba R, Engel J Jr (2018) Getting the best outcomes from epilepsy surgery. Ann Neurol. 83:676–690

    Article  Google Scholar 

  3. Hennessy MJ, Elwes RD, Rabe-Hesketh S, Binnie CD, Polkey CE (2001) Prognostic factors in the surgical treatment of medically intractable epilepsy associated with mesial temporal sclerosis. Acta Neurol Scand 103:344–350

    Article  CAS  Google Scholar 

  4. Jung R, Aull-Watschinger S, Moser D, Czech T, Baumgartner C, Bonelli-Nauer S, Pataraia E (2013) Is reoperation an option for patients with temporal lobe epilepsy after failure of surgery? Seizure 22:502–506

    Article  Google Scholar 

  5. de Tisi J, Bell GS, Peacock JL, McEvoy AW, Harkness WF, Sander JW et al (2011) The long-term outcome of adult epilepsy surgery, patterns of seizure remission, and relapse: a cohort study. Lancet 378:1388–1395

    Article  Google Scholar 

  6. Chen CY, Lee HT, Chen CC et al (2012) Short-term results of vagus nerve stimulation in pediatric patients with refractory epilepsy. Pediatr Neonatol 53:184–187

    Article  Google Scholar 

  7. Hung KL (2012) Vagus nerve stimulation therapy in pediatric epilepsy: current understanding and future directions. Pediatr Neonatol 53:155–156

    Article  Google Scholar 

  8. Ben-Menachem E (2002) Vagus-nerve stimulation for the treatment of epilepsy. Lancet Neurol 1:477–482

    Article  Google Scholar 

  9. Hammond EJ, Uthman BM, Reid SA, Wilder BJ (1992) Electrophysiological studies of cervical vagus nerve stimulation in humans: I. EEG Effects Epilepsia 33:1013–1020

    Article  CAS  Google Scholar 

  10. Tsai JD, Chang YC, Lin LC, Hung KL, VNS TCNS (2016) The neuropsychological outcome of pediatric patients with refractory epilepsy treated with VNS–A 24-month follow-up in Taiwan. Epilepsy Behav. 56:95–98

    Article  Google Scholar 

  11. Fan HC, Hsu TR, Chang KP, Chen SJ, Tsai JD, VNS TCNS (2018) Vagus nerve stimulation for 6- to 12-year-old children with refractory epilepsy: Impact on seizure frequency and parenting stress index. Epilepsy Behav. 83:119–123

    Article  Google Scholar 

  12. Boling W (2018) Diagnosis and surgical treatment of epilepsy. Brain Sci. 8(7):E115

    Article  Google Scholar 

  13. Spencer S, Huh L (2008) Outcomes of epilepsy surgery in adults and children. Lancet Neurol 7:525–537

    Article  Google Scholar 

  14. Surges R, Elger CE (2013) Reoperation after failed resective epilepsy surgery. Seizure 22(7):493–501

    Article  Google Scholar 

  15. Jehi L, Sarkis R, Bingaman W, Kotagal P, Najm I (2010) When is a postoperative seizure equivalent to ‘‘epilepsy recurrence’’ after epilepsy surgery? Epilepsia 51:994–1003

    Article  Google Scholar 

  16. Muthaffar O, Puka K, Rubinger L, Go C, Snead OC 3rd, Rutka JT, Widjaja E (2017) Reoperation after failed resective epilepsy surgery in children. J Neurosurg Pediatr 20(2):134–140

    Article  Google Scholar 

  17. Elliott RE, Morsi A, Tanweer O et al (2011) Efficacy of vagus nerve stimulation over time: review of 65 consecutive patients with treatment-resistant epilepsy treated with VNS %3e 10 years. Epilepsy Behav 20:478–483

    Article  Google Scholar 

  18. Orosz I, McCormick D, Zamponi N et al (2014) Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia 55:1576–1584

    Article  Google Scholar 

  19. Elliott RE, Rodgers SD, Bassani L et al (2011) Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases. J Neurosurg Pediatr 7:491–500

    Article  Google Scholar 

  20. Elliott RE, Morsi A, Geller EB, Carlson CC, Devinsky O, Doyle WK (2011) Impact of failed intracranial epilepsy surgery on the effectiveness of subsequent vagus nerve stimulation. Neurosurgery 69(6):1210–1217

    Article  Google Scholar 

  21. Vale FL, Ahmadian A, Youssef AS, Tatum WO, Benbadis SR (2011) Long-term outcome of vagus nerve stimulation therapy after failed epilepsy surgery. Seizure 20(3):244–248

    Article  Google Scholar 

Download references

Funding

The study was supported by Taiwan Child Neurology Society and Chung Shan Medical University (CSH-2016-a-018).

Author information

Authors and Affiliations

Authors

Consortia

Corresponding authors

Correspondence to Huei-Shyong Wang or Kuang-Lin Lin.

Ethics declarations

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, or publication of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsai, JD., Fan, PC., Lee, WT. et al. Vagus nerve stimulation in pediatric patients with failed epilepsy surgery. Acta Neurol Belg 121, 1305–1309 (2021). https://doi.org/10.1007/s13760-020-01303-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-020-01303-8

Keywords

Navigation