Vagus nerve stimulation therapy for treatment-resistant XXXX : A 15-year experience at a single institution.

@entity1 @entity410 @entity146 @entity128 @entity302
OBJECTIVE: @entity302 ( @entity302 ) occurs in 20-30% of @entity1 . The goal of this study is to assess the efficacy and safety of vagus nerve stimulation (VNS) in this group of @entity1 , including adult and pediatric populations and several off-label indications. METHODS: This is a retrospective review of 59 consecutive @entity1 in whom 60 VNS devices were implanted at a single institution during a 15-year period. @entity1 were evaluated in the @entity302 was performed. The series included indications not approved by the FDA, such as @entity1 under 12 years of age, pregnancy and right-sided VNS. Performing the procedure on an out- @entity1 basis was recently adopted, minimizing hospital length of stay. RESULTS: There were 42 adults and 17 @entity1 (14 under 12 years of age) and the mean age at implantation was 26 years. Duration of VNS therapy ranged from 6 months to 9 years. For the entire cohort, the mean percentage @entity410 reduction was 31.37%. Twenty @entity1 (34.48%) were considered responders ( @entity410 reduction >= 50%); 7 @entity1 (12.06%) had @entity410 reduction of >= 75% and 2 @entity1 had @entity410 control of >= 90% (3.4%). The @entity1 in whom right-sided VNS was implanted achieved the same reduction in @entity410 burden and the @entity1 who became pregnant could reduce antiepileptic drugs dosage, without complications. Side-effects were mild and there were no permanent @entity128 . One @entity1 died in the follow-up due to @entity146 previously known. CONCLUSIONS: VNS is a safe and effective palliative treatment for @entity302 @entity1 . There are an increasing number of indications and further randomized trials would potentially expand the number of @entity1 who may benefit from it. A multidisciplinary team is crucial for a complete preoperative evaluation and selection of the optimal candidates for the treatment.
