Abstracts

Rationale: Vagus nerve stimulation (VNS) is standard of care for patients with intractable epilepsy who are not candidates for surgery or have failed surgery. Epilepsy in the elderly is common, and VNS may be a particularly good option for such patients, who may be more sensitive to medication side effects. Our objective was to report a series of patients implanted with VNS after the age of 65. Methods: We reviewed our database (from 2000 to 2017) to identify patients newly implanted with VNS after the age of 65. Only new implants were counted. Revisions (battery replacements) were not included. Outcome was obtained by clinic follow up visits or when necessary phone calls to patients. Results: We identified 12 patients who received VNS at the age of 65 years or older. This represents 2.5% of new VNS implants in the same time period.Two patients were lost to follow up. Of the ten assessed:Efficacy: Eight (80%) had a greater than 50% seizure frequency reduction, including four (40%) with an 80% or greater seizure frequency reduction. Two (20%) had a less than 50% improvement (one of the two only had a 3-month follow up).Safety: none reported any serious adverse events.Tolerability: three reported significant side effects (two hoarseness, and one "anxiety"). Conclusions: VNS is a safe and effective option in patients who are 65 years of age or older. Although our numbers are small, efficacy may be higher in this population than in younger patients, possibly because epilepsy in this age group tends to be less intractable. Funding: No funding