Retrospective Study On The Efficacy And Influential Factors Of Vagus Nerve Stimulation In Patients With Refractory Epilepsy

Objective: To retrospectively study the patients with refractory epilepsy who underwent left vagus nerve stimulation(VNS)to explore whether the operation is effective and whether there are any adverse reactions,and to explore the influencing factors of postoperative efficacy in order to further predict the postoperative effect.Methods:The clinical data of 12 patients with drug-refractory epilepsy on left vagus nerve stimulation(VNS)at the Department of Neurosurgery,Tianjin Medical University General Hospital between January 2016 and January 2017 were collected,including type of epilepsy,age of implantation,age of seizure,Onset time,adverse reactions,medication,postoperative stimulation parameters and other factors,Follow-up time of not less than 1 year,statistical preoperative and postoperative seizure frequency,the difference between the two and to observe the operation is effective and efficient,of which the baseline The frequency was compared with the incidence of preoperative January in patients.After the operation,the patients were observed whether there were any adverse reactions or whether the adverse reactions were relieved.The factors such as gender,course of disease,type of seizure,frequency of preoperative seizure,output current and stimulation period Postoperative efficacy is related to the frequency of epileptic seizures decreased before and after surgery data by chi-square test,P <0.05 indicates a statistically significant Conclusion: Twelve patients with refractory epilepsy had an average age of 25.4 years(range,7 to 68 years)at implantation and a median seizure time of 11.76 years(range,2 to 30 years).The seizure frequency decreased 60.17%(SD = 19.08)on average after 12 months.10 cases(83.3%)in which the frequency of seizures decreased ?50% and the frequency of seizures decreased ?75%(3 cases)There were 2 cases(16.7%)with frequency reduction <50% and only 1 case with frequency reduction <25%.The frequency of preoperative seizures was high(more than 10 times per day),and statistics were made on the frequency of preoperative and postoperative seizures.Compared with preoperative and postoperative differences were statistically significant(P = 0.015).At 6,9,and 12 months,the effective rate(50% reduction in episodes or more)was 33.3%,41.6%,and 83.3%,respectively.This ratio shows a significant increase in this proportion between 6 and 12 months.More common adverse reactions observed were hoarse voice,mild coughing and anorexia,etc.,were gradually relieved in about six months.The gender,type of seizure,frequency of seizure(preoperative),output current,stimulation period and postoperative efficacy of the patients were investigated respectively.Univariate and multivariate analysis were performed.The results showed that the type and duration of seizure and the postoperative efficacy Closely related(p <0.05).Gender,frequency of preoperative seizures,output current,duration of stimulation,and postoperative outcome were not significantly correlated(p> 0.05).