Subgroup analysis of seizure and cognitive outcome after vagal nerve stimulator implantation in children.
Drug-resistant epilepsy
Epilepsy
PEDSQL™
Pediatric neurosurgery
Psychomotor development
Quality of life
Seizures
Vagal nerve stimulator
Journal
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
23
02
2020
accepted:
16
04
2020
pubmed:
4
5
2020
medline:
25
6
2021
entrez:
4
5
2020
Statut:
ppublish
Résumé
Vagal nerve stimulator (VNS) implantation at an early age seems to lead to improved quality of life and cognitive outcome. The aim of this analysis is to evaluate whether specific patient or seizure characteristics might lead to better seizure control, cognitive outcome, and higher quality of life in children undergoing VNS implantation. Primary outcome measure was reduction in seizure frequency. Secondary outcome measures were epilepsy outcome assessed by McHugh and Engel classifications, reduction in antiepileptic drugs (AED), developmental and cognitive outcome, as well as quality of life assessed through the pediatric quality of life (PEDSQL™) questionnaire and care giver impression (CGI) scale. Forty-five consecutive children undergoing VNS implantation were analyzed for the following subgroups: age (categorized to 1-2 years old, 3-5 years old, 6-12 years old, and 13-18 years old), sex, underlying cause (categorized to idiopathic, encephalitis, stroke, syndromic), duration of preoperative seizures (dichotomized to under or above 89 months, corresponding to the median of the whole cohort), and preoperative seizure frequency (dichotomized to under and above 360 seizures per month). Encephalitis as the underlying cause for seizures was the only variable significantly associated with higher reduction rate of seizure frequency. Patients with VNS implantation at the age of ≤ 2 years showed a strong association with better developmental and cognitive outcome, as well as quality of life. Shorter duration of preoperative seizures and higher preoperative seizure frequency showed a strong association with better developmental outcome, as well as quality of life. Engel outcome scores were significantly better in patients with epilepsy due to encephalitis (100% Engel I-III). However, patients with epilepsy due to encephalitis showed significantly higher complication rates (71.4%, p = 0.045). Children suffering from epilepsy due to encephalitis show higher seizure reduction rates after VNS implantation when compared with children suffering from epilepsy due to other causes. Developmental and cognitive outcomes as well as quality of life of children undergoing VNS implantation is strongly associated with shorter duration of preoperative seizures and implantation at a young age.
Identifiants
pubmed: 32361930
doi: 10.1007/s00381-020-04628-0
pii: 10.1007/s00381-020-04628-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
243-252Références
Eriksson KJ, Koivikko MJ (1997) Prevalence, classification, and severity of epilepsy and epileptic syndromes in children. Epilepsia 38:1275–1282. https://doi.org/10.1111/j.1528-1157.1997.tb00064.x
doi: 10.1111/j.1528-1157.1997.tb00064.x
pubmed: 9578522
Ramos-Lizana J, Aguilera-López P, Aguirre-Rodríguez J, Cassinello-García E (2009) Response to sequential treatment schedules in childhood epilepsy. Seizure 18:620–624. https://doi.org/10.1016/j.seizure.2009.07.001
doi: 10.1016/j.seizure.2009.07.001
pubmed: 19656692
Mohanraj R, Brodie MJ (2006) Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neurol 13:277–282. https://doi.org/10.1111/j.1468-1331.2006.01215.x
doi: 10.1111/j.1468-1331.2006.01215.x
pubmed: 16618346
Berg AT, Shinnar S, Levy SR, Testa FM, Smith-Rapaport S, Beckerman B (2001) Early development of intractable epilepsy in children: a prospective study. Neurology 56:1445–1452. https://doi.org/10.1212/WNL.56.11.1445
doi: 10.1212/WNL.56.11.1445
pubmed: 11402099
Berg AT, Wusthoff C, Shellhaas RA, Loddenkemper T, Grinspan ZM, Saneto RP, Knupp KG, Patel A, Sullivan JE, Kossoff EH, Chu CJ, Massey S, Valencia I, Keator C, Wirrell EC, Coryell J, Millichap JJ, Gaillard WD (2019) Immediate outcomes in early life epilepsy: a contemporary account. Epilepsy Behav 97:44–50. https://doi.org/10.1016/j.yebeh.2019.05.011
doi: 10.1016/j.yebeh.2019.05.011
pubmed: 31181428
Soleman J, Knorr C, Datta AN, Strozzi S, Ramelli GP, Mariani L, Guzman R (2018) Early vagal nerve stimulator implantation in children: personal experience and review of the literature. Childs Nerv Syst 34:893–900. https://doi.org/10.1007/s00381-017-3694-5
doi: 10.1007/s00381-017-3694-5
pubmed: 29255920
Soleman J, Stein M, Knorr C, Datta AN, Constantini S, Fried I, Guzman R, Kramer U (2018) Improved quality of life and cognition after early vagal nerve stimulator implantation in children. Epilepsy Behav 88:139–145. https://doi.org/10.1016/j.yebeh.2018.09.014
doi: 10.1016/j.yebeh.2018.09.014
pubmed: 30269032
Healy S, Lang J, Te Water Naude J et al (2013) Vagal nerve stimulation in children under 12 years old with medically intractable epilepsy. Childs Nerv Syst 29:2095–2099. https://doi.org/10.1007/s00381-013-2143-3
doi: 10.1007/s00381-013-2143-3
pubmed: 23681311
Elliott RE, Rodgers SD, Bassani L, Morsi A, Geller EB, Carlson C, Devinsky O, Doyle WK (2011) Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases. J Neurosurg Pediatr 7:491–500. https://doi.org/10.3171/2011.2.PEDS10505
doi: 10.3171/2011.2.PEDS10505
pubmed: 21529189
Alexopoulos AV, Kotagal P, Loddenkemper T, Hammel J, Bingaman WE (2006) Long-term results with vagus nerve stimulation in children with pharmacoresistant epilepsy. Seizure 15:491–503. https://doi.org/10.1016/j.seizure.2006.06.002
doi: 10.1016/j.seizure.2006.06.002
pubmed: 16859931
Thompson EM, Wozniak SE, Roberts CM, Kao A, Anderson VC, Selden NR (2012) Vagus nerve stimulation for partial and generalized epilepsy from infancy to adolescence. J Neurosurg Pediatr 10:200–205. https://doi.org/10.3171/2012.5.PEDS11489
doi: 10.3171/2012.5.PEDS11489
pubmed: 22768964
Coykendall DS, Gauderer MWL, Blouin RR, Morales A (2010) Vagus nerve stimulation for the management of seizures in children: an 8-year experience. J Pediatr Surg 45:1479–1483. https://doi.org/10.1016/j.jpedsurg.2010.02.066
doi: 10.1016/j.jpedsurg.2010.02.066
pubmed: 20638528
Cersósimo RO, Bartuluchi M, Fortini S, Soraru A, Pomata H, Caraballo RH (2011) Vagus nerve stimulation: effectiveness and tolerability in 64 paediatric patients with refractory epilepsies. Epileptic Disord 13:382–388. https://doi.org/10.1684/epd.2011.0479
doi: 10.1684/epd.2011.0479
pubmed: 22258042
Colicchio G, Policicchio D, Barbati G, Cesaroni E, Fuggetta F, Meglio M, Papacci F, Rychlicki F, Scerrati M, Zamponi N (2010) Vagal nerve stimulation for drug-resistant epilepsies in different age, aetiology and duration. Childs Nerv Syst 26:811–819. https://doi.org/10.1007/s00381-009-1069-2
doi: 10.1007/s00381-009-1069-2
pubmed: 20091042
Orosz I, McCormick D, Zamponi N, Varadkar S, Feucht M, Parain D, Griens R, Vallée L, Boon P, Rittey C, Jayewardene AK, Bunker M, Arzimanoglou A, Lagae L (2014) Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia 55:1576–1584. https://doi.org/10.1111/epi.12762
doi: 10.1111/epi.12762
pubmed: 25231724
Bodin E, Le Moing A-G, Bourel-Ponchel E et al (2016) Vagus nerve stimulation in the treatment of drug-resistant epilepsy in 29 children. Eur J Paediatr Neurol 20:346–351. https://doi.org/10.1016/j.ejpn.2016.01.011
doi: 10.1016/j.ejpn.2016.01.011
pubmed: 26922364
Zamponi N, Rychlicki F, Corpaci L, Cesaroni E, Trignani R (2008) Vagus nerve stimulation (VNS) is effective in treating catastrophic 1 epilepsy in very young children. Neurosurg Rev 31:291–297. https://doi.org/10.1007/s10143-008-0134-8
doi: 10.1007/s10143-008-0134-8
pubmed: 18446391
Yu C, Ramgopal S, Libenson M, Abdelmoumen I, Powell C, Remy K, Madsen JR, Rotenberg A, Loddenkemper T (2014) Outcomes of vagal nerve stimulation in a pediatric population: a single center experience. Seizure 23:105–111. https://doi.org/10.1016/j.seizure.2013.10.002
doi: 10.1016/j.seizure.2013.10.002
pubmed: 24309238
Varni JW, Seid M, Rode CA (1999) The PedsQL: measurement model for the pediatric quality of life inventory. Med Care 37:126–139. https://doi.org/10.1097/00005650-199902000-00003
doi: 10.1097/00005650-199902000-00003
Tsai J-D, Chang Y-C, Lin L-C, Hung K-L (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. https://doi.org/10.1016/j.yebeh.2015.12.030
doi: 10.1016/j.yebeh.2015.12.030
pubmed: 26851647
Menascu S, Kremer U, Schiller Y, Blatt I, Watemberg N, Boxer M, Goldberg H, Korn-Lubetzki I, Steinberg M, Ben-Zeev B (2013) The Israeli retrospective multicenter open-label study evaluating vagus nerve stimulation efficacy in children and adults. Isr Med Assoc J 15:673–677
pubmed: 24511646
Hallböök T, Lundgren J, Stjernqvist K, Blennow G, Strömblad LG, Rosén I (2005) Vagus nerve stimulation in 15 children with therapy resistant epilepsy; its impact on cognition, quality of life, behaviour and mood. Seizure 14:504–513. https://doi.org/10.1016/j.seizure.2005.08.007
doi: 10.1016/j.seizure.2005.08.007
pubmed: 16176878
Thompson PJ, Duncan JS (2005) Cognitive decline in severe intractable epilepsy. Epilepsia 46:1780–1787. https://doi.org/10.1111/j.1528-1167.2005.00279.x
doi: 10.1111/j.1528-1167.2005.00279.x
pubmed: 16302858
Vendrame M, Alexopoulos AV, Boyer K, Gregas M, Haut J, Lineweaver T, Wyllie E, Loddenkemper T (2009) Longer duration of epilepsy and earlier age at epilepsy onset correlate with impaired cognitive development in infancy. Epilepsy Behav 16:431–435. https://doi.org/10.1016/j.yebeh.2009.08.008
doi: 10.1016/j.yebeh.2009.08.008
pubmed: 19767243
Livanova MRI Guidelines for VNS Therapy®. http://omamedical.fi/en/wp-content/uploads/sites/2/2018/09/MRI-Guidelines-for-VNS-Therapy-2018.pdf . Accessed 22 Feb 2020
Englot DJ, Chang EF, Auguste KI (2011) Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response. J Neurosurg 115:1248–1255. https://doi.org/10.3171/2011.7.JNS11977
doi: 10.3171/2011.7.JNS11977
pubmed: 21838505
Elliott RE, Morsi A, Kalhorn SP, Marcus J, Sellin J, Kang M, Silverberg A, Rivera E, Geller E, Carlson C, Devinsky O, Doyle WK (2011) Vagus nerve stimulation in 436 consecutive patients with treatment-resistant epilepsy: long-term outcomes and predictors of response. Epilepsy Behav 20:57–63. https://doi.org/10.1016/j.yebeh.2010.10.017
doi: 10.1016/j.yebeh.2010.10.017
pubmed: 21144802
Ji T, Yang Z, Liu Q, Liao J, Yin F, Chen Y, Zou L, Li B, Gao Y, Shu X, Huang S, Gao F, Liang J, Lin SF, Peng J, Song S, Wang J, Che C, Sun W, Tian M, Yang L, Hua Y, Hao Y, Cai L, Li L, Jiang Y (2019) Vagus nerve stimulation for pediatric patients with intractable epilepsy between 3 and 6 years of age: study protocol for a double-blind, randomized control trial. Trials 20:44. https://doi.org/10.1186/s13063-018-3087-4
doi: 10.1186/s13063-018-3087-4
pubmed: 30642370
pmcid: 6332620