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首页> 外文期刊>Epilepsy currents >Evidence-Based Guideline Update: Vagus Nerve Stimulation for the Treatment of Epilepsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology
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Evidence-Based Guideline Update: Vagus Nerve Stimulation for the Treatment of Epilepsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology

机译：基于证据的指南更新：迷走神经刺激治疗癫痫：美国神经病学会指南制定小组委员会报告

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OBJECTIVE: To evaluate the evidence since the 1999 assessment regarding efficacy and safety of vagus nerve stimulation (VNS) for epilepsy, currently approved as adjunctive therapy for partial-onset seizures in patients >12 years. METHODS: We reviewed the literature and identified relevant published studies. We classified these studies according to the American Academy of Neurology evidence-based methodology. RESULTS: VNS is associated with a >50% seizure reduction in 55% (95% confidence interval [CI] 50%–59%) of 470 children with partial or generalized epilepsy (13 Class III studies). VNS is associated with a >50% seizure reduction in 55% (95% CI 46%–64%) of 113 patients with Lennox-Gastaut syndrome (LGS) (4 Class III studies). VNS is associated with an increase in ≥50% seizure frequency reduction rates of ~7% from 1 to 5 years postim-plantation (2 Class III studies). VNS is associated with a significant improvement in standard mood scales in 31 adults with epilepsy (2 Class III studies). Infection risk at the VNS implantation site in children is increased relative to that in adults (odds ratio 3.4, 95% CI 1.0–11.2). VNS is possibly effective for seizures (both partial and generalized) in children, for LGS-associated seizures, and for mood problems in adults with epilepsy. VNS may have improved efficacy over time. RECOMMENDATIONS: VNS may be considered for seizures in children, for LGS-associated seizures, and for improving mood in adults with epilepsy (Level C). VNS may be considered to have improved efficacy over time (Level C). Children should be carefully monitored for site infection after VNS implantation. Neurology® 2013;81:1–7.
机译：目的：评估自1999年评估以来有关迷走神经刺激（VNS）治疗癫痫的有效性和安全性的证据，目前已批准将迷走神经刺激作为辅助疗法用于12岁以上患者的部分发作。方法：我们回顾了文献并确定了相关的已发表研究。我们根据美国神经病学学会循证方法对这些研究进行了分类。结果：VNS与470名部分或广泛性癫痫患儿的癫痫发作减少> 55％（95％置信区间[CI] 50％–59％）相关（> 13）。 VNS与113名Lennox-Gastaut综合征（LGS）患者的癫痫发作减少55％（95％CI 46％–64％）> 50％相关（4项III类研究）。 VNS与植入后1至5年内癫痫发作频率降低≥50％的比率增加约7％有关（两项III类研究）。 VNS与31名癫痫成人的标准情绪量表的显着改善相关（两项III类研究）。与成人相比，儿童VNS植入部位的感染风险有所增加（赔率3.4，95％CI 1.0-11.2）。 VNS可能对儿童癫痫发作（部分和全身性癫痫发作），与LGS相关的癫痫发作以及癫痫成人的情绪问题有效。随着时间的流逝，VNS可能会改善疗效。建议：VNS可考虑用于儿童癫痫发作，与LGS相关的癫痫发作以及改善癫痫成人的情绪（C级）。可以认为VNS随着时间推移具有更高的疗效（C级）。 VNS植入后应仔细监测儿童的部位感染。 Neurology®2013; 81：1–7。

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