Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox–Gastaut syndrome

Hilde M. Braakman; Joke Creemers; Danny M. Hilkman; Sylvia Klinkenberg; Suzanne M. Koudijs; Mariette Debeij-van Hall; Erwin M. Cornips

Epilepsy and Behavior Case Reports (Jan 2018)

Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox–Gastaut syndrome

Hilde M. Braakman,
Joke Creemers,
Danny M. Hilkman,
Sylvia Klinkenberg,
Suzanne M. Koudijs,
Mariette Debeij-van Hall,
Erwin M. Cornips

Affiliations

Hilde M. Braakman: Department of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC+, PO Box 61, 5591 VE Heeze, the Netherlands; Corresponding author at: Department of Neurology, Academic Center for Epileptology, PO Box 61, 5591 VE Heeze, the Netherlands.
Joke Creemers: Department of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC+, PO Box 61, 5591 VE Heeze, the Netherlands
Danny M. Hilkman: Department of Neurology, Maastricht UMC+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands
Sylvia Klinkenberg: Department of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC+, PO Box 61, 5591 VE Heeze, the Netherlands; Department of Neurology, Maastricht UMC+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands
Suzanne M. Koudijs: Department of Neurology, Maastricht UMC+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands
Mariette Debeij-van Hall: Department of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC+, PO Box 61, 5591 VE Heeze, the Netherlands
Erwin M. Cornips: Department of Neurosurgery, Maastricht UMC+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands

Journal volume & issue: Vol. 10
pp. 111 – 113

Abstract

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We report a child with Lennox–Gastaut syndrome with an increase in seizure frequency and loss of psychomotor skills due to a disintegrated cervical VNS lead, not detected during standard device monitoring. The lead was completely removed and replaced by a new 303 lead on the same nerve segment. After reinitiating VNS, side effects forced us to switch it off, resulting in immediate seizure recurrence. EEG recording demonstrated a non-convulsive status epilepticus that was halted by reinitiating VNS therapy. Thereafter, he remained seizure free for eight months, and regained psychomotor development. Keywords: Lennox–Gastaut syndrome, Refractory epilepsy, Revision surgery, Seizure freedom, Vagus nerve stimulation

Published in Epilepsy and Behavior Case Reports

ISSN: 2213-3232 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: http://www.journals.elsevier.com/epilepsy-and-behavior-case-reports/

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