Vagal stimulation for control of complex partial seizures in medically refractory epileptic patients.

Chronic intermittent stimulation of the vagus nerve is a new method currently being tested for the treatment of medically intractable complex partial seizures (CPS). We have studied the effects of vagal stimulation in nine patients with CPS for 4-16 months to determine its safety and efficacy. With...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 14; no. 1; pp. 108 - 116
Autores principales: Wilder BJ, Uthman BM, Hammond EJ
Formato: Journal Article
Publicado: Wiley-Blackwell Jan1991
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan1991
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Vagal stimulation for control of complex partial seizures in medically refractory epileptic patients.
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          Wilder BJ
          Uthman BM
          Hammond EJ
      sug:
        subj:
          Electrotherapy Equipment and Supplies
          Epilepsy, Partial Therapy
          Vagus Nerve Physiology
          Adult
          Carbamazepine Therapeutic Use
          Communication Equipment and Supplies
          Electrocardiography
          Electrocardiography, Ambulatory
          Electrodes, Implanted
          Electroencephalography
          Epilepsy, Partial Drug Therapy
          Equipment Design
          Evoked Potentials
          Female
          Gastric Acid
          Male
          Middle Age
          Phenytoin Therapeutic Use
          Prostheses and Implants
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Chronic intermittent stimulation of the vagus nerve is a new method currently being tested for the treatment of medically intractable complex partial seizures (CPS). We have studied the effects of vagal stimulation in nine patients with CPS for 4-16 months to determine its safety and efficacy. With the patients maintained on constant dosages of antiepileptic drugs, we recorded the electroen-cephalogram and electrocardiogram, and performed clinical laboratory tests and gastric analysis over a 6-week baseline period. The neurocybernetic prosthesis (NCP) was then implanted and connected to two spiral electrodes wound around the left vagus nerve. After a 4-week placebo period, vagal stimulation was started. Stimulation parameters were increased stepwise at monthly intervals until patients were being stimulated for 30-second periods at 20-50 Hz with 1-2 mA of current at 250-500-|micro;,sec pulses. A second 4-week placebo period was added 3 months after the implantation. Thereafter, vagal stimulation was resumed and self-stimulation with magnetic activation was allowed for a 1-minute period at the onset of an aura. Six patients had a significant reduction in the frequency, intensity, or duration of seizures. All patients tolerated the implantation and stimulation well and none reported pain, discomfort, or important changes in their daily activities, sleep habits, eating, swallowing, or breathing. There were no remarkable changes in blood pressure or heart rate.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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