成人耐药癫痫患者迷走神经刺激后的长期疗效和生活质量变化。

IF 2.9 3区 医学 Q2 CLINICAL NEUROLOGY
Edyta Zwolińska, Marcin Birski, Szymon Hoppe, Dariusz Paczkowski, Marek Harat
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引用次数: 0

摘要

背景与目的:目前有必要了解迷走神经刺激(VNS)的疗效和生活质量(QoL)结果。确定最有可能从VNS获益的患者有助于他们的选择,减少副作用,并改善结果。在这里,我们研究了耐药癫痫患者VNS后的临床和生活质量结果,并试图确定反应预测因素。方法:对2004-2018年间55例手术治疗的耐药癫痫患者进行回顾性研究,其中40例符合纳入分析的条件。所有的手术都是由一位在癫痫治疗方面经验丰富的神经外科医生在一位主治神经科医生的转诊后按照标准方案进行的。通过医疗记录和28项VNS前后癫痫发作频率、持续时间、强度问卷,以及术后并发症的数量和类型及其对患者的意义,以及基于31项癫痫生活质量问卷的生活质量,收集数据。结果:65%使用VNS治疗的耐药癫痫患者癫痫发作频率、持续时间和强度均有改善。最常见的并发症是声音嘶哑(70%),12%的患者对并发症的耐受性较差。20%的患者需要反复手术更换电池或电极。健康状态是唯一受VNS显著影响的QoL参数。未发现显著的疗效预测因子。结论:治疗第一个月的疗效是VNS长期预后的重要指标。如果刺激器不能提供任何好处,可以将其移除。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Efficacy and Quality-of-Life Changes After Vagus Nerve Stimulation in Adult Patients With Drug-Resistant Epilepsy.

Background and purpose: There is a current need to understand the efficacy and quality of life (QoL) outcomes of vagus nerve stimulation (VNS). Identifying patients most likely to benefit from VNS could aid in their selection, reduce side effects, and improve outcomes. Here we studied clinical and QoL outcomes after VNS in patients with drug-resistant epilepsy and attempted to identify response predictors.

Methods: This was a retrospective study of 55 patients with drug-resistant epilepsy treated surgically during 2004-2018, 40 of whom were eligible for inclusion in the analysis. All surgeries were performed using a standard protocol by a neurosurgeon experienced in epilepsy treatment after referral by an attending neurologist. Data were collected from medical records and through a 28-item questionnaire on seizure frequency, duration, and strength before and after VNS, as were the number and type of postoperative complications and their significance to the patient, and QoL based on the 31-item Quality of Life in Epilepsy questionnaire.

Results: Improvements in seizure frequency, duration, and strength were observed in 65% of the patients with drug-resistant epilepsy treated using VNS. The most common complication was hoarseness (70%), and complications were poorly tolerated by 12% of the patients. Repeated surgery to replace batteries or electrodes was required in 20% of the patients. Health status was the only QoL parameter significantly impacted by VNS. No significant efficacy predictors were identified.

Conclusions: Efficacy across the first month of treatment is a strong indicator of long-term outcomes of VNS. The stimulator can be removed if it does not provide any benefit.

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来源期刊
Journal of Clinical Neurology
Journal of Clinical Neurology 医学-临床神经学
CiteScore
4.50
自引率
6.50%
发文量
0
审稿时长
>12 weeks
期刊介绍: The JCN aims to publish the cutting-edge research from around the world. The JCN covers clinical and translational research for physicians and researchers in the field of neurology. Encompassing the entire neurological diseases, our main focus is on the common disorders including stroke, epilepsy, Parkinson''s disease, dementia, multiple sclerosis, headache, and peripheral neuropathy. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, and letters to the editor. The JCN will allow clinical neurologists to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism.
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