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Vagus Nerve Stimulation for Epilepsy: The Notre-Dame Hospital Experience

Published online by Cambridge University Press:  02 December 2014

Mehdi Qiabi ,
Alain Bouthillier ,
Lionel Carmant  and
Dang Khoa Nguyen
Mehdi Qiabi
Affiliation:
Division of Neurology, Montreal University Hospital Centre, Montreal, Quebec, Canada
Alain Bouthillier
Affiliation:
Division of Neurosurgery Notre-Dame Hospital, Montreal University Hospital Centre, Montreal, Quebec, Canada
Lionel Carmant
Affiliation:
Division of Neurology, Montreal University Hospital Centre, Montreal, Quebec, Canada
Dang Khoa Nguyen*
Affiliation:
Division of Neurology, Montreal University Hospital Centre, Montreal, Quebec, Canada
*
Neurology Service, Notre-Dame Hospital, 1560 rue Sherbrooke Est, Montréal, Québec, H2L 4M1, Canada
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Abstract

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Purpose:

Retrospective study assessing the efficacy and tolerability of vagus nerve stimulation (VNS) for the treatment of refractory epilepsy at Notre-Dame Hospital.

Methodology:

Chart review of all adult epileptic patients treated by VNS with ≥ 1 year follow-up. Responders were defined as patients with ≥ 50% reduction of baseline seizure frequency.

Results:

Thirty-four patients (14M; mean age = 29.9 yrs) received a VNS. Sub-pectoralis implantation (n = 25) was more frequent than subcutaneous (n = 9). Most patients suffered from intractable partial epilepsy. After 6 months, 12 months, 24 months, and 36 months, 14/34 patients (41%), 16/34 patients (47%), 17/30 patients (57%) and 12/20 patients (60%) respectively were responders. Two patients (6%) became seizure-free. Complications related to implantation were minor: eight cases of limited cervical hypoesthesia, two minor scar infections and one Horner syndrome. Adverse events (voice hoarseness, throat paresthesia, coughing) related to stimulation were generally mild and tended to wane over time. However, a reduction in seizure frequency did not translate into a reduction in medication, as only 9% of responders had less antiepileptic medication at last follow-up compared to baseline.

Conclusion:

VNS as practiced at Notre-Dame hospital is an efficacious and safe treatment for refractory epilepsy. Quotas allotted to epilepsy centers in the province of Quebec should be lifted or increased to allow more patients to benefit from this therapeutic device.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 6 , November 2011 , pp. 902 - 908
Copyright
Copyright © The Canadian Journal of Neurological 2011

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