Abstract Details

Title Responsive Vagal Nerve Stimulation in Lennox Gastaut Syndrome (LGS) and Intractable Pediatric Epilepsy: URMC VNS Clinic Experience

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P12 - Poster Session 12 (12:00 PM-1:00 PM)

Poster/Presentation
Number 12-009

Objective To assess the utility of VNS within our center in reducing the utilization of benzodiazepine rescue medications, status epilepticus, and ER visits.

Background Starting in January 2017, the University of Rochester Epilepsy Center began to place responsive VNS devices (Aspire®, SenTiva®) in pediatric patients primarily with LGS diagnoses, creating a cohort of patients in a dedicated VNS clinic with extensive pre- and post- treatment data, standardized advancement of VNS programming, and uniform assessment of efficacy of the intervention.

Design/Methods Charts of patients with VNS placed at URMC from Jan2017-Aug2019 were reviewed for seizure frequency, medication adjustments, utilization of rescue medications (confirmed with pharmacy information), frequency of ER visits or hospitalizations, adverse events, side effects, and VNS programming and operating parameters. Patient information was compared to their own historical seizure frequency, benzodiazepine usage, etc, in the 3-6 months prior to VNS placement noted in their pre-implantation and immediate post-operative visits.

Results During this period 30 pediatric patients underwent placement of responsive VNS generators (8 were battery replacements). 3 patients (10%) experienced significant adverse events (including failure of the device, infection/sepsis, etc). There was a decrease in utilization of benzodiazepine-based rescue medications with increase in the voltage and decrease in off-time of the VNS in the majority of patients. Frequency of ER visits and seizure related hospitalization was low, and not determined to be significantly different. No specific quality of life (QOL) evaluation was utilized during this treatment period, but patients and families reported improved subjective QOL in the VNS clinic setting after the intervention.

Conclusions Responsive VNS is an effective intervention in the URMC pediatric epilepsy population to reduce exposure to rescue medications and the frequency of seizure cluster and status epilepticus. Duration of treatment at URMC may be too short to show reduction in seizure frequency for patients with the most complex epilepsy syndromes.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Inna Hughes, MD, PhD (University of Rochester Medical Center)	No disclosure on file

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Abstract Details