Abstracts

Rationale: Vagus nerve stimulation (VNS) plays a crucial role in the management of medically intractable epilepsy can also improve the attention, mood and behavior of epileptic patients. The latter benefit has been attributed to better seizure control, though a direct effect on the neural substrates that control behavior has been hypothesized. Autistic patients with intractable epilepsy provide a unique opportunity to examine the dual effect of VNS on seizures and behavior. Methods: To determine the effect of VNS activity on the behavior of autistic children, we conducted a retrospective case study on 14 autistic children with intractable epilepsy who underwent VNS implantation in the years 2003-2010 and followed their clinical course in the following year. Medical records and parent reports were used to evaluate their seizure and behavioral profile. Results: Eleven out of the fourteen patients showed improvement in alertness and behavior in the year following VNS implantation, while only 9/14 showed significant seizure control. Three of the five patients with little or no change in seizure control made gains in their behavioral profile.Conclusions: In this small cohort of autistic patients with intractable epilepsy, VNS was associated with steady improvement in behavior and quality-of-life in the majority of patients. Behavioral improvements occurred in patients with no improvement in seizure control, suggesting a direct effect of VNS on attention and behavior.