Background: Vagus nerve stimulation (VNS) represents an adjunctive surgical option for adult and pediatric patients with drug-resistant epilepsy, who are not eligible for surgical resection or disconnection. However, little is known on its efficacy in the treatment of Epilepsia Partialis Continua (EPC), a rare but serious form of motor status epilepticus associated either with progressive or with non-evolving neurological diseases.
Purpose and methods: To evaluate the effect of VNS in a series of four children affected by medically unresponsive EPC secondary to chronic inflammatory encephalopathy (two cases), Rasmussen encephalitis (one case) and poliodystrophy (one case).
Results: After VNS implantation, the stimulation amplitude was progressively increased and, after a mean interval of 47 days, a partial reduction of EPC and associated focal seizures was observed in all patients. After a mean follow-up of three years, one child stopped EPC, two presented short and rare episodes and in one patient 2-3 residual seizures per day was reported. In all cases, reduction of epileptic activity was associated with mild improvement of motor and cognitive abilities. No serious side effects were reported.
Conclusion: VNS may be considered as an option for EPC when medical treatment fails and other more invasive neurosurgical options are not feasible.
Keywords: ACDs; CBZ; CLB; CZP; Drug-resistant epilepsy; EPC; Epilepsia Partialis Continua; IVIG; LVT; MDZ; NZP; OXC; PB; PHT; PRM; RE; Rasmussen's encephalitis; SE; TPM; VNS; VPA; Vagus nerve stimulation; ZNS; anticonvulsant drugs; carbamazepine; clobazam; clonazepam; intravenous immunoglubulins; leviracetam; midazolam; nitrazepam; oxcarbamazepine; phenitoyne; phenobarbital; primidone; status epilepticus; topiramate; vagus nerve stimulation; valproic acid; zonisamide.
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