Vagus Nerve stimulation as adjunctive therapy for control of medically resistant epilepsy

Introduction: Vagus Nerve stimulation is recently accepted for treatment of patients with medically refractory epilepsy who are unsuitable candidates for conventional epilepsy surgery. It is approved by the U.S. Food and Drug Administration for the treatment of refractory partial seizures in adolescents and adults. The exact mechanisms of action are unknown. Although the use of vagus nerve stimulation in children has increased, including those younger than 12 years of age or those with generalized epilepsy, there has been no large controlled pediatric study to date. The identification of favorable prognostic indicators, especially in children, would be useful. Preliminary results suggest that children with Lennox-Gastaut syndrome may have a favorable response, with improvement in both seizure control and global evaluation scores. Improved global evaluation scores have occurred even without an associated improvement in seizure control. In this interventional clinical study we have used this method in eighteen patients (5 children and 13 adults) with medically refractory epilepsy for the first time in Iran.