The Efficacy and Safety of Rapid Cycling Vagus Nerve Stimulation in Children With Intractable Epilepsy
The Efficacy and Safety of Rapid Cycling Vagus Nerve Stimulation in Children With Intractable Epilepsy
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DOI：
10.1016/j.pediatrneurol.2020.04.003
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发表时间：
2020-08-01
影响因子：
3.8
通讯作者：
Abdelmoity, Ahmed
中科院分区：
文献类型：
--
作者：
Kayyali, Husam;Abdelmoity, Sherouk;Abdelmoity, Ahmed
目的：迷走神经刺激（VNS）是治疗耐药性癫痫的有效辅助疗法。然而，缺乏有关优化刺激参数以提高疗效的信息。我们的研究检验了快速工作周期 VNS（关闭时间 = 50%）的安全性和有效性。切换到快速占空比后，该比率增加至 77.3%，并在上次快速占空比访问时保持在 77.4%。 15 名患者 (34.1%) 在转为快速循环后对 VNS 有反应；另有 19 名（43.2%）保持了他们的反应，癫痫发作减少率大多有所改善。只有少数情况下，响应者在切换到快速工作周期后变成了无响应者。结论：快速工作周期 VNS 可能是安全的且耐受性良好；对于某些患者来说，它也可能比常规循环 VNS 更有效。这项研究强调了前瞻性、长期、双盲研究的必要性，以了解这种 VNS 模式的优点。 (C) 2020 Elsevier Inc. 保留所有权利。
Purpose: Vagus nerve stimulation (VNS) is an effective adjunctive therapy for drug-resistant epilepsy. Nevertheless, information is lacking regarding optimization of stimulation parameters to improve efficacy. Our study examines the safety and efficacy of rapid duty cycle VNS (OFF time = 50%). This rate increased to 77.3% after switching to rapid duty cycle and remained at 77.4% at the last rapid duty cycle visit. Fifteen patients (34.1%) became responders to VNS after switching to rapid cycling; another 19 (43.2%) maintained their response with mostly improved seizure reduction rates. In only a few instances, responders became nonresponders after switching to rapid duty cycle.Conclusions: Rapid duty cycle VNS is probably safe and well tolerated; it may also be more efficacious than regular cycling VNS in some patients. This study highlights the necessity of prospective, long-term, double-blinded studies for understanding the advantages of this VNS modality. (C) 2020 Elsevier Inc. All rights reserved.