迷走神经刺激治疗药物难治性癫痫的随访研究(附62例分析)

Following-up of curative effect of vagus nerve stimulation on intractable epilepsy (report of 62 cases)

目的研究迷走神经刺激治疗药物难治性癫痫的疗效。方法回顾性分析62例接受迷走神经刺激(VNS)治疗的药物难治性癫痫患者的临床资料。通过患者来院或电话对患者的发作频率、持续时间和生活质量等进行随访。结果 62例患者,失访5例,1例患者刺激时间小于2个月未纳入统计范围,对接受迷走神经刺激治疗3～40个月的56例患者进行统计分析,McHughI级22例(39.3%),Ⅱ级16例(28.6%),Ⅲ级13例(23.2%),Ⅳ级+V级5例(8.9%)。其中3例(5.4%)术后无发作,38例(67.9%)发作减少50%以上。结论迷走神经刺激是治疗药物难治性癫痫安全、有效的方法。VNS刺激时间和刺激参数可能是影响其对药物难治性癫痫疗效的重要因素,随刺激时间延长疗效增加。

Objective To explore the curative effect of vagus nerve stimulation （VNS） on intractable epilepsy. Methods The clinical data of 62 patients with intractable epilepsy, who were treated by VNS, were analyzed retrospectively. Of 62 patients, 56 were followed up from 3 to 40 months, 5 lost following-up and 1 who received VNS treatment for less than 2 months was not followed up. Results The following-up showed that of 56 patients, 22 （39.3%） belonged in MCHugh grade Ⅰ , 16 （28.6%） in grade Ⅱ, 13 （23.2%）iln grade Ⅲ and 5 （8.9%） in grades Ⅳ-Ⅴ. Seizure was totally controlled in 3 patients. Seizure frequenee decreased by more than 50% in 38 patients. Conclusions VNS is a safe and effective method to treat the intractable epilepsy. VNS may make seizure frequency reduce over 50% in more than 60% patients with intractable epilepsy. The present results suggested that the curative effect is correlated with the stimulation parameter and duration.