Abstracts

Some studies have suggested that use of vagal nerve stimulation (VNS) results in improved quality of life (QOL) in patients with medically refractory epilepsy. These study designs compared pre- and post-implantation levels of QOL, but did not compare QOL between epileptic patients with and without VNS. Because of these positive findings, we wanted to investigate further to find out whether these effects were applicable to sexual function and satisfaction in addition to general quality of life. In this preliminary study we sought to compare levels of QOL and sexual function and satisfaction between epileptic patients with and without VNS. In a different study we sent surveys to 50 patients with nonepileptic seizures (NES) and 50 patients with epileptic seizures (ES). The survey included two standardized, previously validated psychiatric diagnostic instruments, the QOLIE-10 and the Arizona Sexual Experiences Scale (ASEX) The QOLIE includes 10 questions assessing the effects of seizures and AEDs on functioning and quality of life. The ASEX has five questions assessing sexual function and satisfaction. We extracted data for epileptic patients with and without VNS from the ES cohort of survey respondents. Data were analyzed using SPSS for Windows. There were 9 epileptic patients being managed with medication alone (ES group) and 3 epileptic patients treated with medications and vagal nerve stimulation (VNS group). All VNS patients and 8 ES patients were female. There was no statistically significant difference in age between the groups (p = 0.98). On the QOLIE-10 survey, VNS patients were significantly less likely to report having memory difficulties than the ES patients (p = 0.03). There was a trend indicating that the VNS group had fewer work limitations (p = 0.12) On the ASEX, VNS patients had lower scores on all five measures (lower scores indicate greater sexual function and satisfaction). On two of the five measures there were trends toward statistical significance. VNS patients reported less troubles with physiological arousal (p = 0.12) and greater ease achieving orgasm (p = 0.09). There were no statistically significant differences in quality of life, energy, mood, social limitations, mental or physical effects of AEDs or fear of having a seizure. VNS patients were significantly less likely to report memory problems than epileptic patients managed with medication alone. This is in agreement with other published studies. They reported fewer work limitations. All scores on the ASEX indicated greater sexual function and satisfaction among the patients with VNS, with a positive trend toward significance on physiological arousal and ability to achieve orgasm. These preliminary results need to be confirmed with larger numbers of patients. (Supported by Cyberonics, Inc.)