Affiliations: Department of Pediatric Neurology and Movement
Disorders, Oakwood Health System, Dearborn, MI, USA | Department of Pediatric Neurology, Neuroscience
Centre, King Fahad Medical City, Riyadh, Saudi Arabia | Department of Neurosurgery, Henry Ford Health System,
Detroit, MI, USA | Operating Room Services, Oakwood Health System,
Dearborn, MI, USA
Note: [] Correspondence: Dr. Yasser Awaad,
Department of Pediatric Neurology, King Fahad Medical City, Riyadh,
Saudi Arabia. Tel.: +966 12889999; Fax: +966 12889999; E-mail:
[email protected]
Abstract: During the past decade, vagus nerve stimulation has become an
accepted treatment method for patients with refractory epilepsy who are not
proper candidates for invasive, potentially curative epilepsy surgery such as
lesionectomy or mesial temporal lobectomy. We aimed to review our clinical
experience with vagus nerve stimulation in a pediatric and young adolescent
population specifically focusing on the necessary special considerations for
these young patients and on surgical pearls in this age group. This is a single
center study from the Oakwood Hospital Epilepsy Clinic in which all our
consecutively enrolled patients were followed as a cohort with ongoing
concurrent as well as retrospective review of in-patient and outpatient
records. All patients (n=30) had a technically successful initial implantation
procedure, but four (13%) required additional interventions. This included six
revisions for mechanical causes, pectoral dehiscence and explants as well as
re-implantation. Epilepsy control improved remarkably in 20 patients (67%)
resulting in an improved quality of life for the majority of our patients.
Appropriate technical modification and attention to detail is needed in these
young patients to achieve optimal surgical results.
