The effects of vagus nerve stimulation therapy on patients with
intractable seizures and either Landau-Kleffner syndrome or autism.
Park YD.
Department of Neurology (child), Medical College of Georgia, 1120 15th Street,
Room BG 2000H, 30912, Augusta, GA, USA
Acquired and developmental comorbid conditions, including language and
behavioral disorders, are often associated with epilepsy. Although the
relationship between these disorders is not fully understood, their close
association may indicate that they share common features, suggesting that these
conditions may respond to the same therapies. Not only has vagus nerve
stimulation (VNS) therapy been proven to reduce the frequency of
pharmacoresistant seizures in epilepsy patients, but preliminary studies also
indicate that VNS therapy may improve neurocognitive performance. On the basis
of these findings, we hypothesized that VNS therapy would improve the quality of
life of patients with either Landau-Kleffner syndrome (LKS) or autism,
independent of its effects on seizures. Data were retrospectively queried from
the VNS therapy patient outcome registry (Cyberonics, Inc; Houston, TX, USA). A
constant cohort of 6 LKS patients and 59 autistic patients were identified.
Among the LKS patients, 3 patients at 6 months experienced at least a 50%
reduction in seizure frequency as compared with baseline. Physicians reported
quality-of-life improvements in all areas assessed for at least 3 of the 6
children. More than half of the patients with autism (58%) experienced at least
a 50% reduction in seizure frequency at 12 months. Improvements in all areas of
quality of life monitored were reported for most patients, particularly for
alertness (76% at 12 months). Although these preliminary findings are
encouraging, a prospective study using standardized measurement tools specific
to these disorders and a longer-term follow-up are necessary to better gauge the
efficacy of VNS therapy among these patient populations.
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