Efficacy Analysis Of The Vagus Nerve Stimulation (VNS) Therapy On Children With Refractory Epilepsy

OBJECTIVE: To explore the efficacy of the vagus nerve stimulation(VNS)therapy on children with refractory epilepsy.METHODS:The clinical data of 52 children with intractable epilepsy who underwent VNS surgery in the neurosurgery department of our hospital from October 2016 to May 2020 were retrospectively analyzed.RESULTS : The patients were followed up for 4 to 46 months.According to McHugh classification,there were 18,10,11,0 and 13 cases of Ⅰ～Ⅴ,respectively,with a percentage of 34.6%,19.2%,21.2%,0.0% and25.0%.Postoperative Less than 12 months、12 to 24 months、24 to 36months、More than 36 months,With the prolongation of VNS stimulation time,the seizures of children gradually decreased.the effective rates of VNS treatment were 30.80%,55.56%,61.54% and 75.00%.Univariate analysis showed that sex,course of disease,age and type of seizures had no effect on the efficacy of VNS(P<0.05),VNS can be used to treat refractory epilepsy of different ages,different courses and types of seizures.The level of intelligence has an effect on the curative effect of VNS,and the curative effect of VNS is better in children with normal intelligence.According to the evaluation of children’s quality of life scale,the social function,school performance and emotional function of children were significantly improved1 year after VNS(P<0.05).When the stimulation current intensity was less than 1mA,the effective rate of VNS was 70.00%,and the incidence of side effects was 15.00%;while the effective rate of children with current intensity less than 1mA was 43.75%,the rate of non-attack was 6.25%,and the incidence of side effects was 31.25%.In this group,18 children gradually stopped antiepileptic drugs after operation,and their quality of life was improved to a higher extent,and the overall quality of life was better.CONCLISONS : VNS can be used to treat refractory epilepsy of different ages,different courses and types of seizures.The level of intelligence before operation has an impact on the efficacy.VNS can significantly reduce the frequency of seizures in children with refractory epilepsy.With the prolongation of the treatment time,the efficacy will be gradually increased,and children’s quality of life in all dimensions will also been improved to different degrees compared with that before.Low stimulation intensity(≤1mA)can produce a better effect on children,and the incidence of side effects is lower.The withdrawal of antiepileptic drugs after VNS may not affect the efficacy of VNS,but also help to reduce the drug burden,reduce the side effects caused by antiepileptic drugs,and promote the intellectual development of children.