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.

Objective:To investigate the clinical value of free-talk language functional cortex mapping methods based on high frequency response in epileptic foci resection.Methods:Twenty patients with intractable epilepsy admitted to our hospital from January 2016 to May 2019 were chosen in our study. According to the different intraoperative mapping methods of language functional region, these patients were divided into test group ( n=10, using free-talk language function localization based on high frequency response [new method]+ electrical cortical stimulation [ECS]) and control group ( n=10, using ECS localization only). The overlap rate of the two methods in the test group were calculated and the postoperative follow-up results of patients in the two groups were analyzed. Results:In 10 patients from the test group, 33 positive loci in the Broca's area and 33 positive loci in the Wernicke's area were detected by new method; at the meantime, 16 positive loci in the Broca's area and 8 positive loci in the Wernicke's area were detected by ECS method, which had a overlap rate of 93.75% (15/16) in the Broca's area and 75.00% (6/8) in the Wernicke's area, respectively, as compared with the new method. In the 10 patients from the control group, 18 positive loci in the Broca's area and 3 positive loci in the Wernicke's area were detected by ECS method. In the test group, 7 patients achieved Engel grading I and 2 patients developed transient language function impairment after surgery; while in the control group, 5 patients achieved Engel grading I and 4 patients developed transient language function impairment after surgery.Conclusion:The new method has a high overlap rate with ECS method; the combination of the two methods can help to decrease the speech function impairment after excision of epileptogenic foci in patients with epilepsy.