Vagus nerve stimulation for drug-resistant Epilepsia Partialis Continua: report of four cases.

Abstract

BACKGROUND:

Vagus nerve stimulation (VNS) represents an adjunctive surgical option for adult and pediatric patients with drug-resistant epilepsy, who are not eligible for surgical resection or disconnection. However, little is known on its efficacy in the treatment of Epilepsia Partialis Continua (EPC), a rare but serious form of motor status epilepticus associated either with progressive or with non-evolving neurological diseases.

PURPOSE AND METHODS:

To evaluate the effect of VNS in a series of four children affected by medically unresponsive EPC secondary to chronic inflammatory encephalopathy (two cases), Rasmussen encephalitis (one case) and poliodystrophy (one case).

RESULTS:

After VNS implantation, the stimulation amplitude was progressively increased and, after a mean interval of 47 days, a partial reduction of EPC and associated focal seizures was observed in all patients. After a mean follow-up of three years, one child stopped EPC, two presented short and rare episodes and in one patient 2-3 residual seizures per day was reported. In all cases, reduction of epileptic activity was associated with mild improvement of motor and cognitive abilities. No serious side effects were reported.

CONCLUSION:

VNS may be considered as an option for EPC when medical treatment fails and other more invasive neurosurgical options are not feasible.

• Authors: Alessandro De Benedictis, Elena Freri, Michele Rizzi, Angelo Franzini, Francesca Ragona, Nicola Specchio, Erika Rebessi, Marina Casazza, Tiziana Granata, Carlo Efisio Marras
• Journal: Epilepsy research (Epilepsy Res) Vol. 107 Issue 1-2 Pg. 163-71 (Nov 2013) ISSN: 1872-6844 [Electronic] Netherlands
• PMID: 24074541 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Child
• Diffuse Cerebral Sclerosis of Schilder (complications)
• Encephalitis (complications)
• Epilepsia Partialis Continua (etiology, therapy)
• Female
• Humans
• Retreatment
• Treatment Outcome
• Vagus Nerve Stimulation (methods)
• Young Adult