Effects Of Vagus Nerve Stimulation On Cognitive Efficiency In School-age Children With Refractory Epilepsy

Objective:This study is designed to investigate the effects of vagus nerve stimulation on cognitive efficiency in school-age children with refractory epilepsy.Methods: 35 school-age children(aged 6-14)with refractory epilepsy were treatd in anhui province hospital neurosurgery ward during January 2016 to January2018,we used neuroimaging and neural electrophysiology and other comprehensive assessment,prompted to extensive,multifocal lesions performance,or lesions located in important functional areas,unable to do surgical operation after vagus nerve stimulation.We used wechsler intelligence scale for the fourth edition of Chinese(WISC-?)on children with cognitive efficiency to test the children in preoperative 7 days,after 12 months respectively,evaluated cognitive efficiency change before and after operation,and we used McHugh efficacy grading to evaluate the effect of surgical treatment after surgery.We choosed 30 healthy school-age children as control group,used WISC-? to test the cognitive efficiency during this period,evaluated the change situation and compared with epilepsy group.Results: After VNS,we followed up 35 refractory epilepsy school-age children for 12 months,the frequency of seizure was reduced by more than 80% in 10 children,by 50%~ 79% in 15 children,and by < 50% in 7 children.Two children benefited from the use of magnets,but one did not improve.We used McHugh to grade the efficacy,the result was?-?level 25 cases,cognitive efficiency score increased(9.56±2.42),? level 7cases,score increased(4.23±1.34),?-?level 3 cases,score increased(1.87±0.56),the classification of cognitive efficiency score difference was statistically significant(P< 0.05).The increase score of cognitive efficiency(8.67±1.78)after VNS was higher than that in the control group(1.01 ± 0.43),and the difference was statistically significant(P<0.05).Conclusion:Vagus nerve stimulation is safe and effective in the treatment of refractory epilepsy in school-age children,which can reduce the frequency of seizures and improve the cognitive efficiency of children.The better the control effect of seizures,the more significant the improvement of cognitive efficiency.