Journal of Pediatric Epilepsy 2016; 05(01): 007-010
DOI: 10.1055/s-0035-1567851
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Vagal Nerve Stimulation: Is It Effective in Children with Dravet Syndrome?

Deepa Sirsi
1   Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Muna Khan
1   Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Susan T. Arnold
1   Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
› Author Affiliations
Further Information

Publication History

10 December 2014

16 June 2015

Publication Date:
19 November 2015 (online)

Abstract

Treatment of Dravet syndrome with anti-seizure medications is challenging and frequently disappointing in early childhood. Nonpharmacologic treatments for epilepsy including ketogenic diet, corpus callosotomy, and vagal nerve stimulation (VNS) are considered and used for management of medically refractory epilepsy. In this series, we report our experience with VNS in eight children with Dravet syndrome. Mean age at VNS implantation was 6.2 years. Duration of treatment with VNS ranged from 2 to 13 years. When compared with baseline, four of eight children had a 50 to 75% reduction in seizure frequency or duration. Four children had no significant improvement in seizures after VNS. The device was well tolerated in all patients without significant complications.

 
  • References

  • 1 Martinos MM, Yoong M, Patil S , et al. Early developmental outcomes in children following convulsive status epilepticus: a longitudinal study. Epilepsia 2013; 54 (6) 1012-1019
  • 2 Dravet C. The core Dravet syndrome phenotype. Epilepsia 2011; 52 (52) (Suppl. 02) 3-9
  • 3 Dravet C, Bureau M, Dalla Bernardina B, Guerrini R. Severe myoclonic epilepsy in infancy (Dravet syndrome) 30 years later. Epilepsia 2011; 52 (52) (Suppl. 02) 1-2
  • 4 Brunklaus A, Ellis R, Reavey E, Forbes GH, Zuberi SM. Prognostic, clinical and demographic features in SCN1A mutation-positive Dravet syndrome. Brain 2012; 135 (Pt 8): 2329-2336
  • 5 Chiron C, Marchand MC, Tran A , et al. Stiripentol in severe myoclonic epilepsy in infancy: a randomised placebo-controlled syndrome-dedicated trial. STICLO study group. Lancet 2000; 356 (9242) 1638-1642
  • 6 Kwan P, Arzimanoglou A, Berg AT , et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010; 51 (6) 1069-1077
  • 7 Coppola G, Capovilla G, Montagnini A , et al. Topiramate as add-on drug in severe myoclonic epilepsy in infancy: an Italian multicenter open trial. Epilepsy Res 2002; 49 (1) 45-48
  • 8 Genton P, Velizarova R, Dravet C. Dravet syndrome: the long-term outcome. Epilepsia 2011; 52 (52) (Suppl. 02) 44-49
  • 9 Caraballo RH. Nonpharmacologic treatments of Dravet syndrome: focus on the ketogenic diet. Epilepsia 2011; 52 (52) (Suppl. 02) 79-82
  • 10 Cersósimo RO, Bartuluchi M, De Los Santos C, Bonvehi I, Pomata H, Caraballo RH. Vagus nerve stimulation: effectiveness and tolerability in patients with epileptic encephalopathies. Childs Nerv Syst 2011; 27 (5) 787-792
  • 11 Chieffo D, Battaglia D, Lettori D , et al. Neuropsychological development in children with Dravet syndrome. Epilepsy Res 2011; 95 (1–2) 86-93
  • 12 Zamponi N, Passamonti C, Cappanera S, Petrelli C. Clinical course of young patients with Dravet syndrome after vagal nerve stimulation. Eur J Paediatr Neurol 2011; 15 (1) 8-14
  • 13 Orosz I, McCormick D, Zamponi N , et al. Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia 2014; 55 (10) 1576-1584