Effects Of Different Treatment Modes After Vagus Nerve Stimulation On The Efficacy Of Drug-resistant Epilepsy Patients

PurposeTo investigate the effects of different treatment modes of vagus nerve stimulation(VNS)on the efficacy and complications of drug refractory epilepsy(DRE).MethodRetrospective analysis of clinical data of 56 patients with drug-refractory and systemic epilepsy admitted to the Affiliated Hospital of Zhengzhou University.All patients were treated with left VNS after long-term drug treatment.Among them,26 patients underwent normal mode and 30 patients under magnet mode.The initial stimulation parameters of all patients were:stimulation current of 0.25 mA,frequency of 30 Hz,stimulation time of 30 s,intermittent time of 5 min,and pulse width of 500 its.The temporary stimulation current controlled by the magnet is higher than the normal current of 0.2mA to 0.3mA,the stimulation time is 1min,and the pulse width is 500us.During the 12-month follow-up,the patient's stimulus current intensity increased in appropriate units.Follow-up observations were made of outbreak frequency,severity,and complications through follow-up visits or telephone follow-up.COX regression models and survival analysis were used to analyze.The effectiveness of the two was statistically analyzed and evaluated according to the McHugh classification criteria to analyze the difference in postoperative efficacy.ResultDuring follow-up of 3,6,9,and 12 months,the effective rates of 56 patients were 30.3%,42.8%,53.6%,and 64.3%,respectively.Among them,the normal mode(without the use of magnets)has effective rates of 15.3%,30.7%,46.1%,and 57.7%,respectively.The efficiency of magnet mode(using magnet)is 43.3%,53.3%,60%,70%.The COX regression model showed(WaldX2=2.04 P>0.05),the Breslow test suggested(X2=3.91 P<0.05),and the Log-rank test suggested(X2=2.20 P>0.05).In December,McHugh's classification was 5 in normal mode IA,3 in IB,4 in ?A,3 in?B,3 in ?A,8 in ?B,and 4 in V.The magnet model was 4 cases of IA grade,7 cases of ?B grade,8 cases of ?A grade,2 cases of ?B grade,6 cases of IIIA grade,2 cases of ?B grade,and 1 case of V grade.The effectiveness of the two treatment modes and the treatment of patients with no improvement were different in March(P<0.05),There was a significant difference in the degree of seizures in March,June and September(P<0.05),and with the prolongation of stimulation time,the treatment effect showed an increasing trend(P<0.05).There was no statistically significant difference in complications between the two treatment modes(P>0.05).Conclusion1.Both treatment modes are safe and effective in the treatment of DRE,and have a time accumulation effect.2.In the magnet mode,the effectiveness of the patients in the early stage(3 months)is better,and the treatment effect for asymptomatic patients is better than that in the normal mode,and the effect of controlling the onset of the attack is also better than that in the normal mode(3,6,and 9 months).3.There no significant difference in complications between the two.