Maxine Dibué-Adjei, Maxine Dibué-Adjei, Igor Fischer, Hans-Jakob Steiger, Marcel Alexander
Kamp. Efficacy of Adjunctive Vagus Nerve
Stimulation in Patients with Dravet Syndrome: A Meta-Analysis of 68 Patients. Seizure.
In press.
Highlights
•13 studies comprising 68 patients report efficacy of VNS in
Dravet syndrome.
•52.9% of DS patients experienced a ≥50% reduction of
seizures.
•Average seizure reduction, assessed in n = 28 patients was
50.8%.
Abstract
Rationale
Dravet Syndrome (DS) is a severe epileptic encephalopathy of
childhood involving intractable seizures, recurrent status epilepticus and
cognitive decline. Because DS is a rare disease, available data is limited and
evidence-based treatment guidelines are lacking. Vagus nerve stimulation (VNS)
is an established neurostimulation treatment for intractable epilepsy, however
little evidence is published on its efficacy in patients with DS.
Methods
We performed a meta-analysis of all peer-reviewed English
language studies reporting seizure outcomes of patients with DS treated with
adjunctive vagus nerve stimulation. The primary and secondary outcome measures
were ≥50% reduction of seizures or of the most-debilitating seizure type and
seizure reduction per patient.
Results
13 studies comprising 68 patients met the inclusion criteria
of which 11 were single-center retrospective case series, one was a
multi-center retrospective analysis and one was a case report. 52.9% of
patients experienced a ≥50% reduction of seizures and the average seizure
reduction, which could only be assessed in n = 28 patients was 50.8%. 7 out of
13 studies reported additional benefits of VNS, however this could not be
assessed systematically.
Conclusion
Vagus nerve stimulation appears to reduce seizure frequency
in patients with DS. Based on this preliminary analysis, controlled trials of
VNS in this rare condition using patient-centric outcome measures are
indicated.
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