N.-vagusstimulatie bij patiënten met medicatieresistente epilepsie

To describe the mechanism and first results of vagus nerve stimulation at the Medisch Spectrum Twente, the Netherlands, for the treatment of patients with drug-resistant epilepsy.

Design

Descriptive retrospective.

Method

Fifteen patients, 8 male and 7 female, aged 18-45 years with drug-resistant epilepsy, who were not eligible for surgical resection of an epileptic focus, received a vagus nerve stimulator implant in the period April 1999-December 2000. Whilst the vagus nerve stimulator was being adjusted, the medication remained unchanged.

Results

Due to vagus nerve stimulation the mean seizure frequency decreased by 32 (range: +20 to -100). In 6 patients there was a strong reduction in seizure frequency, in 3 there was a mild reduction, and in 6 patients there was no apparent effect. The most common adverse events during stimulation were a mild prickly cough and a change of voice during stimulation. In one patient a temporary left vocal cord paralysis was observed, which may possibly have been a result of the procedure.

Conclusion

Vagus nerve stimulation is an effective means of treatment for drug-resistant epilepsy and is therefore a treatment option that deserves more attention in the Netherlands.