迷走神经刺激术治疗顽固性癫痫初步探讨

Investigation of vagus nerve stimulation for treatment of intractable epilepsy

目的 探讨迷走神经刺激术治疗顽固性癫痫的治疗效果.方法 对21例顽固性癫痫患者进行迷走神经刺激手术治疗,术后2周开机,分次调试参数,脉冲发生器输出电流从0.25 mA逐渐增加,但不超过3.0 mA,刺激时间为30 s,间歇5 min,信号频率为20～30 Hz,脉宽为250～1000μs.对治疗效果进行随访,分析治疗效果.结果 经4-16个月刺激,McHugh Ⅰ级3例,Ⅱ级7例,Ⅲ级9例,Ⅴ级2例.其中10例患者癫痫发作减少50%以上.结论 迷走神经刺激术治疗顽固性癫痫是一种相对安全、有效的治疗方法 .

Objective To investigate the effectiveness of vagus nerve stimulation （VNS） therapy in intractable epilepsy. Methods VNS were performed in twenty - one patients. The generator was turned on 2 weeks after operation. Stimulation parameters were adjusted gradually. The output currents adjusted from 0.25 mA, and less than 3.0 mA. Stimulative time was 30 s ON and 5 min OFF, the frequency was from 20to 30 Hz, and the pulse width was from 250 μs to 1000 μs. The patients were followed up so as to analysis the effectiveness. Results After4 - 16 months of intermittent stimulation of the vagus nerve, grade Ⅰ in 3 patients, grade Ⅱ in 7 patients, grade Ⅲ in 9 patients and grade Ⅴ in 2 patients. Among them, seizure frequency was reduced over 50% occurred in 10 patients. Conclusion VNS can reduce seizure frequency,improve the quality of life in patients with intractable epilepsy, and it is a minimal invasive surgery with few side effects.