Vagus Nerve Stimulation for Symptomatic Generalized Epilepsy: A Pilot Study

Summary: Purpose: Patients with symptomatic generalized epilepsy (SGE) may have antiepileptic drug (AED)-resistant mixed generalized seizures. Vagus nerve stimulation (VNS) reduces partial seizures and may help SGE.
Methods: We added VNS to stable AED therapy in five SGE patients. Nine-month postoperative VNS treatment seizure rates were compared to a 1 -month preoperative baseline.
Results: All patients had mixed generalized seizures, EEG generalized slow spike-and-wave and behavioral abnormalities. Median number of previous AEDs taken was 6 (range 5–12). Median baseline seizure rate was 75honth (range 29–1 10). VNS produced a median seizure rate production of -41% (range -40%–85%). Adverse events reported in one patient each were: incisional infection, choking sensation and voice change; and coughing (noted by two patients). One patient discontinued VNS due to coughing.
Conclusions: We conclude that VNS may be useful add-on therapy for SGE. A larger, controlled, and blinded trial may be warranted.