...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Neurosurgery >Vagus Nerve Stimulation Therapy after Failed Cranial Surgery for Intractable Epilepsy: Results from the Vagus Nerve Stimulation Therapy Patient Outcome Registry.
【24h】

Vagus Nerve Stimulation Therapy after Failed Cranial Surgery for Intractable Epilepsy: Results from the Vagus Nerve Stimulation Therapy Patient Outcome Registry.

机译：难治性癫痫的颅脑手术失败后进行迷走神经刺激治疗：迷走神经刺激治疗患者结果登记册的结果。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To determine the effectiveness of vagus nerve stimulation (VNS) therapy among patients with persistent or recurrent seizures after lobar resection, callosotomy, and other cranial operations for intractable epilepsy. METHODS: Data were obtained from the VNS therapy patient outcome registry, which was established after United States Food and Drug Administration approval of the VNS device in 1997 as a means of capturing open-label clinical data outside of protocol. The integrity of the systems for collecting and processing registry data was authenticated by an independent auditing agency. The effect of potential selection bias, however, remains uncertain. RESULTS: Two nonconsecutive cohorts were compared: patients tracked in the registry who had previously undergone cranial surgery for epilepsy (CS group, n = 921) and those who had not (non-CS group, n = 3822). For the CS group, the median reduction in seizure frequency was 42.5% after 3 months of VNS therapy, 42.9% at 6 months, 45.7% at 12 months, 52.0% at 18 months, and 50.5% at 24 months. For the non-CS group, analogous rates were 47.0%, 52.9%, 60.0%, 62.7%, and 66.7%, respectively. In the CS group, seizures were reduced by at least 50% in 55.1% of patients, at least 75% in 31.4% of patients, at least 90% in 17.3% of patients, and 100% in 5.1% of patients after 24 months of VNS therapy. Response rates were more pronounced in the non-CS group: at least 50% in 62.2% of patients, at least 75% in 43.7% of patients, at least 90% in 26.8% of patients, and 100% in 8.3% of patients. Patients in both groups experienced marked improvements in quality of life parameters. CONCLUSION: The effectiveness of VNS is maintained during prolonged stimulation, and overall seizure control continues to improve with time. Patients in whom prior cranial surgery had failed did not respond as favorably as all other patients receiving VNS therapy. Nonetheless, many of the former group improved substantially. Thus, on the basis of these open-label data, VNS therapy represents a potentially palliative treatment option for patients with refractory seizures after failed cranial surgery.
机译：目的：确定迷走神经刺激（VNS）治疗在大叶切除，call骨切开术和其他颅骨手术后顽固性癫痫持续发作或反复发作​​的患者中的有效性。方法：数据是从VNS治疗患者结果注册表中获得的，该注册表是在1997年美国食品和药物管理局批准VNS设备后建立的，该方法是在协议之外获取开放标签临床数据的一种方法。一个独立的审核机构对收集和处理注册表数据的系统的完整性进行了验证。然而，潜在选择偏差的影响仍然不确定。结果：比较了两个非连续队列：在登记处追踪的先前曾接受过颅脑手术治疗癫痫的患者（CS组，n = 921）和未进行过颅脑手术的患者（非CS组，n = 3822）。对于CS组，VNS治疗3个月后癫痫发作频率的中位数降低为42.5％，6个月为42.9％，12个月为45.7％，18个月为52.0％，24个月为50.5％。对于非CS组，类似率分别为47.0％，52.9％，60.0％，62.7％和66.7％。在CS组中，在24个月后，癫痫发作减少了至少50％（55.1％），至少75％（31.4％），至少90％（17.3％）和100％（5.1％） VNS治疗。非CS组的反应率更为明显：62.2％的患者至少为50％，43.7％的患者至少为75％，26.8％的患者至少为90％，8.3％的患者为10​​0％ 。两组患者的生活质量参数均有显着改善。结论：长时间刺激后，VNS的有效性得以保持，总体癫痫发作控制力随着时间的推移持续改善。先前颅骨手术失败的患者的反应不如接受VNS治疗的所有其他患者好。尽管如此，许多前者还是取得了很大进步。因此，基于这些开放性数据，对于颅脑手术失败后难治性癫痫发作的患者，VNS治疗代表了潜在的姑息治疗选择。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号