Effectiveness of vagus nerve stimulation therapy in refractory hypoxic-ischemic encephalopathy-induced epilepsy

被引：2

作者：

Guo, Mengyi ^{[2
,4
]}

Wang, Jing ^{[4
]}

Tang, Chongyang ^{[1
,2
]}

Deng, Jiahui ^{[2
]}

Zhang, Jing ^{[2
,4
]}

Xiong, Zhonghua ^{[2
,4
]}

Liu, Siqi ^{[2
,4
]}

Guan, Yuguang ^{[1
,2
]}

Zhou, Jian ^{[1
,2
]}

Zhai, Feng ^{[1
,2
]}

Luan, Guoming ^{[1
,2
]}

Li, Tianfu ^{[2
,3
]}

机构：

[1] Capital Med Univ, Sanbo Brain Hosp, Beijing Key Lab Epilepsy Res, Dept Neurosurg,Ctr Epilepsy,Beijing Inst Brain Dis, Beijing 100093, Peoples R China

[2] Capital Med Univ, Sanbo Brain Hosp, Beijing Key Lab Epilepsy Res, Dept Brain Inst,Ctr Epilepsy,Beijing Inst Brain Di, Beijing, Peoples R China

[3] Capital Med Univ, Sanbo Brain Hosp, Beijing Key Lab Epilepsy Res, Dept Neurol,Ctr Epilepsy,Beijing Inst Brain Disord, Xiangshan Yikesong 50, Beijing 100093, Peoples R China

[4] Capital Med Univ, Sanbo Brain Hosp, Beijing Inst Brain Disorders, Dept Neurol,Ctr Epilepsy, Beijing, Peoples R China

来源：

THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS | 2022年 / 15卷

基金：

中国国家自然科学基金;

关键词：

effectiveness; hypoxic-ischemic encephalopathy-induced epilepsy; neonatal seizure; predictor; vagus nerve stimulation; DRUG-RESISTANT EPILEPSY; NEONATAL SEIZURES; ILAE COMMISSION; SERIAL MRI; LONG-TERM; CHILDREN; NEWBORNS; SAFETY; PREDICTORS; EFFICACY;

D O I：

10.1177/17562864221144351

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background:Epilepsy is one of the important long-term sequelae of neonatal hypoxic-ischemic encephalopathy (HIE) and is typically characterized by drug resistance and poor surgical outcomes. Vagus nerve stimulation (VNS) is a promising neuromodulation therapy for refractory epilepsy. Objectives:The present study aimed to first evaluate the effectiveness of VNS in patients with refractory HIE-induced epilepsy and scrutinize potential clinical predictors. Methods:We retrospectively collected the outcomes of VNS in all patients with refractory HIE-induced epilepsy and at least 2 years of follow-up. Subgroups were classified as responders and nonresponders according to the effectiveness of VNS (> 50% or <50% reduction in seizure frequency). Preoperative data were analyzed to screen for potential predictors of VNS effectiveness. Results:A total of 55 patients with refractory HIE-induced epilepsy who underwent VNS therapy were enrolled. Responders represented 56.4% of patients, and 12.7% of patients achieved seizure freedom at the last follow-up. In addition, the responder rate increased over time with rates of 23.6%, 38.2%, 50.9%, and 56.4% at the 3-, 6-, 12- and 24-month follow-ups, respectively. After multivariate analysis, neonatal seizure was identified as a negative predictor (OR: 4.640, 95% CI: 1.129-19.066), and a predominant seizure type of generalized onset was identified as a positive predictor (OR: 0.261, 95% CI: 0.078-0.873) of VNS effectiveness. Conclusion:VNS therapy was effective in patients with refractory HIE-induced epilepsy and was well tolerated over a 2-year follow-up period. VNS therapy demonstrated better effectiveness in patients without neonatal seizures or with a predominant seizure type of generalized onset.

引用

页数：13