TITLE:
Efficacy of Vagus Nerve Stimulation (VNS) after Multiple Subpial Transections (MST) for Extra-Temporal Seizure Foci
AUTHORS:
Arun Angelo Patil, Arun Anthony, Richard Andrews
KEYWORDS:
Vagus Nerve Stimulation; Multiple Subpial Transaction; Intractable Epilepsy
JOURNAL NAME:
Surgical Science,
Vol.4 No.5,
May
7,
2013
ABSTRACT: Background: The effect of Vagus nerve stimulation (VNS) therapy
following major resective surgeries has been reported. However,
the effect of VNS therapy following multiple-subpial-transections (MST) has not
been reported. The objective of this paper is to examine the beneficial effect
of VNS therapy following MST. Methods: There are 22 patients aged 10 - 55
years. Male/female distribution is 11/11 and follow-up is 24 - 148
months (median of 120 months). Seizure foci were bilateral in 9 patients,
multi-lobar (unilateral) in 12 patients and single-lobar in 1 patient. MST was
performed over broad areas in and around the seizure foci. VNS implantation was
done when the response to MST procedure was poor (1 patients), or there was
recurrence of seizures (21 patients). Interval between MST and VNS implanttation
varied from one month to three years (median of 2 years). Results: Thirteen
patients (59%) are seizure free (Engel’ Class I), 8 (36.5%) have greater than
90% reduction in seizure frequency (Class II), and 1 (4.5%) has between 50% - 90%
reduction in seizure frequency (Class III). Conclusion: The results show that VNS therapy
produced meaningful improvement in seizure outcome in all patients with
extra-temporal seizures that had inadequate response
to MST.