The effect of vagus nerve stimulator in controlling status epilepticus in children

Purpose: This study explores the effect of Vagus Nerve Stimulator (VNS) on Status Epilepticus (SE) in children with medically intractable epilepsy. Methods: Retrospective review was conducted in children with a history of at least two SE, who had VNS implantation and had at least one year follow up after the procedure. Results: Sixteen patients met inclusion/exclusion criteria. The median age of seizure onset and surgery was 1.3 years and 9.0 years, respectively. Prior to VNS implantation, 81% (13/16) of patients had ≥one seizure per month when all seizure types were combined. 75% (12/16) of patients experienced ≥one generalized convulsive seizure per month. The median number of SE prior to VNS was three (2–9), and 63% (10/16) had at least one SE during a year prior to implantation. The proportion of patients who did not have any SE one year after VNS implantation increased compared to the year prior (75% vs. 37%, p = 0.07). The seizure frequency decreased in a minority of patients when all seizure types were combined (20% at one year, p = 1.00, 44% at the last follow up, p = 0.55), but generalized convulsive seizure decreased in 69% of patients at one year (p = 0.01) and 75% of patients at last follow up (p = 0.01). Conclusion: VNS appears to have favorable impact on SE and generalized convulsive seizures in children with medically intractable epilepsy.