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
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.
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页数:13
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