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Journal of Neurorestoratology 2020, 8(3): 149-159 https://doi.org/10.26599/JNR.2020.9040017
Case Report | Open Access | Issue | Published: 17 September 2020

Vagal nerve stimulation is effective in pre-school children with intractable epilepsy: A report of two cases

Show Author's Information Zhao Yang1,§,  Ciliu Zhang2,3,§,  Zhiyan Wang1,  Tungyang Cheng1,  Xiaoya Qin1,4,  Jin Deng1,  Xi Fang1,  Hongwei Hao1,  Jing Peng2,3,  Fei Yin2,3( ),  Luming Li1,4,5( )
National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China
Department of Pediatrics, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China
Hunan Intellectual and Developmental Disabilities Research Center of Children, Changsha 410008, Hunan, China
Precision Medicine and Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen 518071, China
Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100069, China

§ These authors contributed equally to this work.

Keywords:
vagal nerve stimulation, pre-school children, intractable epilepsy, Gesell scale, heart rate variability
Cite this article:
Yang Z, Zhang C, Wang Z, et al. Vagal nerve stimulation is effective in pre-school children with intractable epilepsy: A report of two cases. Journal of Neurorestoratology, 2020, 8(3): 149-159. https://doi.org/10.26599/JNR.2020.9040017
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Abstract Full text About this article

There is lack of prospective evidence regarding vagal nerve stimulator (VNS) in younger children with intractable epilepsy. Here, we report the outcomes of using VNS in two pre-school patients for pediatric intractable epilepsy (VNS-PIE) study. Medical treatment was ineffective in both the patients, and they underwent VNS implantation. Seizure frequency, score on the Gesell scale, and heart rate variability (HRV) were assessed following VNS therapy. After 6 months VNS treatment, the seizure frequency in the two patients decreased by 50% from that at baseline, based on the records in their epileptic diary. Video electroencephalography (EEG) examinations showed that abnormal fast waves diminished in the background in Patient 1, and captured seizure frequency in Patient 2 remarkably decreased. The adaptability, language, and individual and social interaction on their Gesell scales increased slightly, suggesting that VNS had a positive effect on the development of these two children. Moreover, the changes in the different HRV indices indicated improved cardiac autonomic function. In conclusion, these two cases indicated that VNS may not only be a superior therapy for pre-school children with intractable epilepsy, but also may exert a positive effect on their mental development and cardiac autonomic function.


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About this article

Vagal nerve stimulation is effective in pre-school children with intractable epilepsy: A report of two cases

Show Author's information Zhao Yang1,§, Ciliu Zhang2,3,§, Zhiyan Wang1, Tungyang Cheng1, Xiaoya Qin1,4, Jin Deng1, Xi Fang1, Hongwei Hao1, Jing Peng2,3, Fei Yin2,3( ), Luming Li1,4,5( )
National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing 100084, China
Department of Pediatrics, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China
Hunan Intellectual and Developmental Disabilities Research Center of Children, Changsha 410008, Hunan, China
Precision Medicine and Healthcare Research Center, Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen 518071, China
Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100069, China

§ These authors contributed equally to this work.

Abstract

There is lack of prospective evidence regarding vagal nerve stimulator (VNS) in younger children with intractable epilepsy. Here, we report the outcomes of using VNS in two pre-school patients for pediatric intractable epilepsy (VNS-PIE) study. Medical treatment was ineffective in both the patients, and they underwent VNS implantation. Seizure frequency, score on the Gesell scale, and heart rate variability (HRV) were assessed following VNS therapy. After 6 months VNS treatment, the seizure frequency in the two patients decreased by 50% from that at baseline, based on the records in their epileptic diary. Video electroencephalography (EEG) examinations showed that abnormal fast waves diminished in the background in Patient 1, and captured seizure frequency in Patient 2 remarkably decreased. The adaptability, language, and individual and social interaction on their Gesell scales increased slightly, suggesting that VNS had a positive effect on the development of these two children. Moreover, the changes in the different HRV indices indicated improved cardiac autonomic function. In conclusion, these two cases indicated that VNS may not only be a superior therapy for pre-school children with intractable epilepsy, but also may exert a positive effect on their mental development and cardiac autonomic function.

Keywords: vagal nerve stimulation, pre-school children, intractable epilepsy, Gesell scale, heart rate variability

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Publication history
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Publication history

Received: 05 June 2020
Revised: 13 August 2020
Accepted: 19 August 2020
Published: 17 September 2020
Issue date: September 2020

Copyright

© The authors 2020

Acknowledgements

We would like to thank the entire team of researchers for their rigorous attitudes, professional skills, enthusiasm for the patients and great efforts, including the nurses and staff at Xiangya Hospital, Changsha, China.

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This article is published with open access at http://jnr.tsinghuajournals.com

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