Vagus Nerve Stimulation for Patients in Residential Treatment Facilities
Abstract number :
2.325
Submission category :
Year :
2001
Submission ID :
1650
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
M.D. Frost, MD, Minnesota Epilepsy Group, P.A., St Paul, MN; R.L. Huf, MD, Epilepsy & Brain Mapping Program, Huntington Memorial Hospital, Pasedena, CA; J.R. Gates, MD, Minnesota Epilepsy Group, P.A., St Paul, MN
RATIONALE: Patients who live in resident treatment facilities (RTF) often have complex behavioral, emotional, physical and cognitive challenges that are exacerbated by medically refractory seizures. This analysis compared the effectiveness of vagus nerve stimulation (VNS) among patients who had intractable seizures and lived in residential treatment facilities with similar patients who did not live in RTFs (non-RTF).
METHODS: We queried the VNS patient outcome registry for a constant cohort of patients with baseline, 3-month and 12-month data. We compared patients who lived in RTFs with those who did not for baseline demographics, median reductions in seizure frequency and quality of life at 3- and 12-month follow-up. Changes over time and differences between treatments were compared with non-parametric methods for original data including the two-sample test and Wilcoxon two-sample test. The signed rank test was used to measure changes within groups. Statistical significance was assumed when p0.05.[lte]
RESULTS: The constant cohort of 776 patients included 86 patients in the RTF group and 690 patients in the non-RTF group. The RTF group had a significantly (P[lt]0.05) larger number of patients with generalized seizures, previous callosotomy, psychiatric disorders, behavioral problems, neurological defects, cognitive challenges and Rett[scquote]s syndrome. Median seizure reductions after three months were 33% in the RTF group and 49% in the non-RTF group (P[lt]0.001); after 12 months, 50% (RTF) and 56% (non-RTF). After both 3 and 12 months, alertness, mood, postictal recovery and cluster seizures improved in more that a third in both groups.
CONCLUSIONS: Although the difference in reductions in seizure frequency was statistically significant at 3-month follow-up, by 12-month follow-up the reductions were similar. Because VNS therapy does not interact with medications and is delivered automatically, it should be seriously considered for patients who live in RTFs and who have intractable epilepsy.
Support: Cyberonics
Disclosure: Consulting - Yes; Materials - Yes; Honoraria - Yes