Abstracts

Medically refractile multifocal epilepsy in infancy can be devastating and exceptionally difficult to treat. We and others have reported favorable results from vagus nerve stimulator therapy in pediatric patients. We have utilized vagus nerve stimulator therapy in a small group of patients whose age is less than 5 years and report results here. We reviewed the medical records and outcomes of 6 patients less than 5 years of age who underwent implantation of a vagal nerve stimulator. All patients were refractile to multiple medications and had severe multi-focal, life altering epilepsy. Six patients were identified. Average age was 23.7 months (range 9-46 months). Underlying diagnoses including mitochondrial disease, atonic seizures and idiopathic multifocal epilepsy (4 patients). Concomitant morbidity included linear nevus sebaceus syndrome (1 patient) and myelomeningocele (1 patient). Surgical procedures were uncomplicated and required an average of 74 minutes for implantation. No child lost more than 10 cc of blood. Follow up time averages 19 months (range 1-61 months). Three children have shown significant improvement in seizure control, one child has not changed and one child is worse. One child was not available for follow up. Vagal Nerve Stimulator therapy is feasible and appears safe and effective in this small cohort of very young children.