迷走神经刺激术治疗癫痫疗效分析及参数调节体会

Curative effect of vagus nerve stimulation on treatment-resistant epilepsy and its parameter modulation

目的探讨迷走神经刺激术治疗癫痫的疗效及参数调节体会。方法对46例药物难治性癫痫患者进行迷走神经刺激手术治疗,术后2-3周开机。分次调试参数,脉冲发生器输出电流从0.25mA逐渐增加,但不超过3.0mA,刺激周期为开30s,间歇5min,频率20-30Hz,脉宽250-1 000μs。刺激8个月以上进行随访。结果随访39例患者,McHugh I级13例,II级11例,III级11例,IV+V级4例。其中4例(10.3%)术后无发作,24例(61.5%)发作减少50%以上。结论迷走神经刺激是治疗成人和儿童药物难治性癫痫安全、有效的方法,超过60%的患者癫痫发作减少50%以上。治疗效果与刺激时间及参数调节有关。

Objective To study the curative effect of vagus nerve stimulation（VNS） on treatment-resistant epilepsy and its parameter modulation.Methods Forty-six treatment-resistant epilepsy patients were treated with VNS 2-3 weeks after operation.Stimulation parameters were adjusted.The output current of generator was gradually increased from 0.25mA to 3.0mA.The stimulation cycle,intermission,frequency and pulse width of the generator were 30s,5min,20-30Hz,and 250-1 000μs,respectively.The patients were followed up for more than 8 months.Results Among the 39 patients who were followed up,McHugh grades I-IV＋V were found in 13,11,11 and 4 patients,respectively.Of these patients,4（10.3%） had no seizure after VNS,24（61.5%） had their seizure reduced over 50%.Conclusion VNS is a safe and effective procedure for children and adult patients with treatment-resistant epilepsy and can reduce their seizure over 50%.Its curative effect is correlated with the parameter modulation and stimulation time