AI Article Synopsis
- The study looks at how many days patients with hard-to-treat epilepsy can go without seizures after getting a treatment called vagus nerve stimulation (VNS).
- They looked at 362 patients over three years and found that only about 11% had complete freedom from all types of seizures for at least a year, but 55% of those with a specific kind of seizure (TCS) did experience this.
- Patients who went a year without any seizures reported that their quality of life got much better compared to those who still had seizures.
Article Abstract
Objective: Amount of seizure-free days is a critical determinant of quality of life (QoL) in patients with drug-resistant epilepsy (DRE). The fractions of patients experiencing prolonged periods of seizure freedom with adjunctive vagus nerve stimulation (VNS) have yet to be assessed on a large scale.
Methods: Retrospective analysis of patients in the Japanese VNS prospective observational registry who experienced at least 1 year of seizure freedom from all seizures, focal seizures, or tonic-clonic seizures (TCS), as well as patient-reported change in QoL in these groups.
Results: The study included 362 patients with DRE, 147 were female (40.6%), and the median age at VNS implant was 23.0 years (range: 1.0-73.0). A total of 225 patients reported focal seizures and 184 patients reported TCS. After 36 months of adjunctive VNS, the cumulative proportion of patients experiencing at least 1 year of complete seizure freedom was 11% (38/356) with an average duration of seizure freedom of 19.4 months. In patients with focal seizures, 25% (n = 57/225) experienced at least 1 year of freedom from focal seizures with an average duration of 24.8 months. Higher cumulative rates of freedom from TCS were observed: 55% (n = 101/184) experienced at least 1 year without TCS with an average duration of TCS-free periods of 28.9 months. 82.1% of patients with 12-month complete seizure freedom reported markedly improved or improved QoL compared with 51.9% of patients who were not seizure-free. QoL changes in patients with 12-month seizure freedom from TCS and focal seizures were similar: 61.8% and 63% of respective patients reported either markedly improved or improved QoL at 36 months.
Significance: Complete seizure freedom is rare in patients treated with VNS; however, this analysis found approximately half of patients who experienced TCS prior to VNS experienced prolonged periods of freedom from TCS with adjunctive VNS.
Plain Language Summary: We studied patients in Japan with epilepsy that is difficult to treat. To understand if adding vagus nerve stimulation (VNS) helps such patients, we looked at which patients stopped having all seizures or stopped having a specific seizure type (such as tonic-clonic seizures or focal seizures), and how long these periods lasted. With VNS treatment, about 2 out of 4 patients with tonic-clonic seizures and 1 out of 4 patients with focal seizures had more time without these seizure types. Without seizures, patients felt better about their daily lives. Even patients who still had seizures felt better about their daily lives after 3 years of VNS treatment.
Trial Registration: The clinical trial registry number is UMIN000014728.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633706 | PMC |
| http://dx.doi.org/10.1002/epi4.13025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Long-term efficacy and safety of perampanel monotherapy in patients with newly diagnosed or currently untreated recurrent focal-onset seizures: Results from the open-label extension phase of FREEDOM (Study 342).
Epilepsy Res
December 2024
Korea University, Guro Hospital, Seoul, Republic of Korea.
Objective: FREEDOM (Study 342; NCT03201900) assessed the long-term treatment effect of perampanel monotherapy in adolescent and adult patients (12-74 years of age) with untreated focal-onset seizures (FOS), with or without focal to bilateral tonic-clonic seizures (FBTCS).
Methods: In the Core Study, after a 4-week Pretreatment Phase, perampanel was up-titrated to 4 mg/day during a 6-week Titration Period followed by a 26-week Maintenance Period. Patients experiencing seizure(s) during the 4-mg/day Maintenance Period could have perampanel up-titrated to 8 mg/day over 4 weeks then could enter the 26-week 8-mg/day Maintenance Period.
The Little-Known Ribbon-Shaped Piriform Cortex: A Key Node in Temporal Lobe Epilepsy-Anatomical Insights and Its Potential for Surgical Treatment.
Diagnostics (Basel)
December 2024
Medical School, Universidad de las Américas (UDLA), Quito 170124, Ecuador.
The piriform cortex (PC) plays a pivotal role in the onset and propagation of temporal lobe epilepsy (TLE), making it a potential target for therapeutic interventions. This review delves into the anatomy and epileptogenic connections of the PC, highlighting its significance in seizure initiation and resistance to pharmacological treatments. Despite its importance, the PC remains underexplored in surgical approaches for TLE.
View Article and Find Full Text PDFThe effect of epilepsy surgery on tonic-clonic seizures.
Epilepsia
January 2025
Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Objective: Epilepsy surgery outcomes tend to be judged by the percentage in seizure reduction without considering the effect on specific seizure types, particularly tonic-clonic seizures, which produce the greatest morbidity and mortality. We assess how often focal to bilateral tonic-clonic seizures (BTCS) stop and how often they appear de novo after epilepsy surgery.
Methods: Analysis of a prospectively maintained epilepsy surgery database between 1986 and 2022 that characterizes the burden of BTCS after resective epilepsy surgery.
Nuclear Medicine Imaging in Epilepsy.
Radiographics
January 2025
From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219 (A.S., A.T.T., B.W.M., L.L.W., J.L.S.); and Department of Radiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH (A.T.T.).
Approximately one-third of patients with focal epilepsy have medically refractory focal epilepsy (MRFE), which significantly impacts their quality of life. Once a seizure focus is identified and determined to be in the noneloquent cortex, it can be surgically resected with the goal of freedom from seizures and minimal neurocognitive deficit. During noninvasive (phase I) presurgical planning, functional (nuclear) imaging and structural imaging are complementary in the accurate localization of the epileptogenic zone (EZ).
View Article and Find Full Text PDFDevelopment of a rapid screener to elicit patient preferences for antiseizure medication discontinuation.
Epilepsy Behav
December 2024
University of Michigan, Department of Neurology, Ann Arbor, MI, USA. Electronic address:
Objective: While guidelines encourage individualized discussions of the risks and benefits of antiseizure medication (ASM) withdrawal after a period of seizure-freedom, no formal methods exist for assessing patient preferences. We report the initial development of a rapid patient preferences screener.
Methods: We conducted a mixed-methods study of adults who were ≥1 year seizure-free and seen for epilepsy across three institutions.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!