Transcutaneus auricular vagus nerve stimulation

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An alternative therapy for drug-resistant epilepsy: transcutaneous auricular vagus nerve stimulation.

Rong P, Liu A, Zhang J, Wang Y, Yang A, Li L, Ben H, Li L, Liu R, He W, Liu H, Huang F, Li X, Wu P, Zhu B.

Chin Med J (Engl). 2014;127(2):300-4.

Purpose:

To examine the effects of transcranial auricular vagus nerve stimulation (ta-VNS) in patients with drug-resistant epilepsy

Methods:

A total of 50 volunteer patients with drug-resistant epilepsy were selected for a random clinical trial. The seizure frequency, quality of life, and severity were assessed in weeks 8, 16, and 24 of the treatment according to the percentage of seizure frequency reduction.

Results:

In the pilot study, 47 of the 50 epilepsy patients completed the 24-week treatment; three dropped off. After 8-week treatment, six of the 47 patients (12%) were seizure free and 12 (24%) had a reduction in seizure frequency. In week 16 of the continuous treatment, six of the 47 patients (12%) were seizure free; 17 (34%) had a reduction in seizure frequency. After 24 weeks’ treatment, eight patients (16%) were seizure free; 19 (38%) had reduced seizure frequency.

Conclusion:

Similar to the therapeutic effect of VNS, ta-VNS can suppress epileptic seizures and is a safe, effective, economical, and widely applicable treatment option for drug-resistant epilepsy.

http://www.ncbi.nlm.nih.gov/pubmed/24438620

Comments reviewer, Prof Van Nieuwenhuizen:

this is an interesting study as non-invasive stimulation of the vagal nerve may be an option to avoid some of the complications of VNS implantation (infection). However, efficacy of ta-VNS compared to implantation-VNS might be significantly lower. In this study 16% were seizure free and 38% had reduced seizure frequency. In the McHugh study regarding implantation-VNS (Epilepsia. 2007 Feb; 48(2):375-8)16.5% had more than 80% seizure reduction, 20% had a seizure reduction between 50-79%, one third did not show any improvement, whereas the remaining patients had a seizure reduction of less than 50% or had only magnet benefit. Complication rate of ta-VNS compared to implantation VNS is low: three out of 47 patients (2.1%) quit the study due to complications. One patient complained of severe dizziness; two patients reported red rashes and swelling.
Non-implantation VNS remains an interesting option: it might enable testing VNS sensibility before implantation is carried out.

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