Frontiers in Neurology (Jun 2020)

Refractory Status Epilepticus in Genetic Epilepsy—Is Vagus Nerve Stimulation an Option?

  • Nicola Specchio,
  • Alessandro Ferretti,
  • Nicola Pietrafusa,
  • Marina Trivisano,
  • Costanza Calabrese,
  • Giusy Carfì Pavia,
  • Alessandro De Benedictis,
  • Carlo Efisio Marras,
  • Luca de Palma,
  • Federico Vigevano

DOI
https://doi.org/10.3389/fneur.2020.00443
Journal volume & issue
Vol. 11

Abstract

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Refractory and super-refractory status epilepticus (RSE, SRSE) are severe conditions that can have long-term neurological consequences with high morbidity and mortality rates. The usefulness of vagus nerve-stimulation (VNS) implantation during RSE has been documented by anecdotal cases and in systematic reviews; however, the use of VNS in RSE has not been widely adopted. We successfully implanted VNS in two patients with genetic epilepsy admitted to hospital for SRSE; detailed descriptions of the clinical findings and VNS parameters are provided. Our patients were implanted 25 and 58 days after status epilepticus (SE) onset, and a stable remission of SE was observed from the seventh and tenth day after VNS implantation, respectively, without change in anti-seizure medication. We used a fast ramp-up of stimulation without evident side effects. Our results support the consideration of VNS implantation as a safe and effective adjunctive treatment for SRSE.

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