Predictive factors for efficacy of vagus nerve stimulation in drug resistant epilepsy
10.3760/cma.j.cn115354-20201022-00835
- VernacularTitle:迷走神经刺激术治疗药物难治性癫痫的疗效预测因素分析
- Author:
Xi ZHANG
1
;
Tao YU
;
Jin ZHU
;
Xiaohua ZHANG
;
Xiaoming YAN
;
Kai MA
;
Liang QIAO
;
Duanyu NI
;
Cuiping XU
;
Yongjie LI
Author Information
1. 首都医科大学宣武医院功能神经外科，北京功能神经外科研究所，北京 100053
- Keywords:
Vagus nerve stimulation;
Drug resistant epilepsy;
Efficacy;
Predictive factor
- From:
Chinese Journal of Neuromedicine
2021;20(5):458-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive factors for efficacy of vagus nerve stimulation (VNS) in drug resistant epilepsy (DRE).Methods:A total of 91 DRE patients underwent VNS in our hospital from July 2015 to August 2019 were chosen in our study. The preoperative evaluation data and postoperative follow-up data were retrospectively analyzed. Univariate Logistic regression analysis and multivariate Logistic regression analysis were used to investigate the predictive factors for efficacy of VNS.Results:One year after VNS, McHugh grading I in 20 patients (22%), grading II in 37 (40.6%), grading III in 23 (25.3%), grading IV in 2 (2.2%), and grading V in 9 (9.9%)were noted. There were 57 patients (62.6%) reached the responder status (seizure frequency reduction≥50%, McHugh grading Ⅰ or Ⅱ), and 34 (37.4%) patients failed to reach the responder status (seizure frequency reduction<50%, McHugh grading Ⅲ-Ⅴ). The univariate Logistic regression analysis showed that the differences in lateralized interictal epileptiform discharge (IED), focal onset, and age of patients accepted electrode implantation were significant between the two groups ( P<0.05). Multivariate Logistic regression analysis demonstrated that the lateralized IDE ( OR=5.214, 95%CI: 1.331-20.431, P=0.018) and focal onset ( OR=4.111, 95%CI: 1.432-11.802, P=0.009) were the independent predictive factors for efficacy of VNS. Conclusion:The lateralized IDE and focal onset can be used as important references for VNS in DRE patients.
