Vagus nerve stimulation in children with refractory seizures associated with Lennox-Gastaut syndrome

Purpose: Vagus nerve stimulation (VNS) is approved for use for refractory p artial seizures. Nevertheless, information regarding VNS therapy for specia l populations, including Lennox-Gastaut syndrome (LGS) is limited. We discu ss the effectiveness, tolerability, and safety of VNS therapy in patients w ith LGS. Methods: A six-center, retrospective study evaluated the effectiveness of V NS therapy in patients with LGS at 3 and 6 months and compared preimplant a nd postimplant seizure frequency. Adverse effects and quality of life (QOL) were included as secondary measures. Results: Fifty patients, median age 13 years, with medically refractory epi lepsy, were implanted. Median age at onset of seizures was 1.4 years, and a median of nine anticonvulsants (AEDs) had been tried before implantation. Data-collection forms were designed for retrospectively gathering data on e ach patient's preimplant history, Seizures, implants, device settings, QOL, and adverse events. Median reductions in total seizures were 42% at 1 mont h, 58.2% at 3 months, and 57.9% at 6 months. The most common adverse events reported were voice alteration and coughing during stimulation. Other unco mmon adverse events included increased drooling and behavioral changes. Inv estigators noted that QOL had improved for some patients in the study. Conclusions: VNS is an effective treatment for medically refractory epileps y in LGS. This treatment is well tolerated, safe, and may improve QOL.