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Research ArticleOriginal Article
Open Access

Vagus nerve stimulation in medically refractory epilepsy: Adverse effects and clinical correlates

Khaled A. Alshehri, Shaima H. Abuhulayqah, Mohammed A. Asiry and Suad A. Alyamani
Neurosciences Journal January 2024, 29 (1) 10-17; DOI: https://doi.org/10.17712/nsj.2024.1.20230006
Khaled A. Alshehri
From the Neuroscience Center (Alshehri, Abuhulayqah, Asiry, Alyamani), King Faisal Specialist Hospital and Research Center, Riyadh, and from the Department of Medicine (Alshehri), Faculty of Medicine, Tabuk University, Tabuk, Kingdom of Saudi Arabia
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  • ORCID record for Khaled A. Alshehri
  • For correspondence: [email protected]
Shaima H. Abuhulayqah
From the Neuroscience Center (Alshehri, Abuhulayqah, Asiry, Alyamani), King Faisal Specialist Hospital and Research Center, Riyadh, and from the Department of Medicine (Alshehri), Faculty of Medicine, Tabuk University, Tabuk, Kingdom of Saudi Arabia
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Mohammed A. Asiry
From the Neuroscience Center (Alshehri, Abuhulayqah, Asiry, Alyamani), King Faisal Specialist Hospital and Research Center, Riyadh, and from the Department of Medicine (Alshehri), Faculty of Medicine, Tabuk University, Tabuk, Kingdom of Saudi Arabia
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Suad A. Alyamani
From the Neuroscience Center (Alshehri, Abuhulayqah, Asiry, Alyamani), King Faisal Specialist Hospital and Research Center, Riyadh, and from the Department of Medicine (Alshehri), Faculty of Medicine, Tabuk University, Tabuk, Kingdom of Saudi Arabia
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Article Figures & Data

Figures

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  • Figure 1
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    Figure 1

    - Minor side effects of VNS therapy.

  • Figure 2
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    Figure 2

    - Major side effects of VNS therapy.

Tables

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    Table 1

    - The Socio-demographic and other features of the patients who underwent VNS implantation (n=43).

    Variablesn (n=43)(%)
    Gender
    Female17(39.5)
    Male26(60.5)
    Age (Years)
    <10 Years19(44.2)
    11–20 Years13(30.2)
    21–30 years3(7.0)
    >30 Years8(18.6)
    Efficacy of VNS treatment
    No improvement10(23.3)
    Lower seizure frequency30(69.8)
    Seizure freedom3(7.0)
    Side effects
    Yes29(67.4)
    No14(32.6)
    Severe side effects
    No35(81.4)
    Yes8(18.6)
    ICU admission
    No37(86.0)
    Yes6(14.0)

    VNS- Vagus Nerve Stimulator, ICU - Intensive Care Unit

      • View popup
      Table 2

      - Epilepsy-related features and investigations in patients who underwent vagus nerve stimulator (VNS) implantation (n=43).

      Variablesn (n=43)(%)
      Age of seizure onset
      < 3 Years28(65.1)
      4-6 Years11(25.6)
      7-9 Years2(4.7)
      >10 Years2(4.7)
      Classification of seizures
      Focal9(20.9)
      Generalized34(79.1)
      Type of generalized seizures
      Bilateral tonic clonic17(39.5)
      Tonic20(46.5)
      Myoclonic14(32.6)
      Atonic13(30.2)
      Absence7(16.3)
      Atypical absence4(9.3)
      Epileptic spasm2(4.7)
      Focal8(18.6)
      Etiology of epilepsy
      Anoxic ischemic injury3(7.0)
      Autoimmune (GAD65)1(2.3)
      Focal cortical dysplasia1(2.3)
      Genetic7(16.3)
      Heterotopia2(4.7)
      Intracerebral hemorrhage1(2.3)
      Ischemic stroke1(2.3)
      Meningoencephalitis5(11.6)
      Occipital calcification1(2.3)
      Unknown21(48.8)
      Prior surgery for epilepsy
      Corpus callosotomy15(34.9)
      Frontal disconnection1(2.3)
      Function hemispherectomy1(2.3)
      Post. quadrant disconnection1(2.3)
      Temporal lobectomy1(2.3)
      EEG
      Focal epileptiform discharges9(20.9)
      generalized and multifocal34(79.1)
      Brain MRI
      Normal11(25.5)
      Calcification1(2.3)
      Cerebral atrophy7(16.2)
      Encephalomalacia10(23.2)
      Focal cortical dysplasia1(2.3)
      Heterotopia4(9.3)
      Hippocampal atrophy3(6.9)
      Intracerebral hemorrhage1(2.3)
      Ischemic insult1(2.3)
      Leukodystrophy1(2.3)
      Polymicrogyria1(2.3)
      Schizencephaly1(2.3)
      Temporal lobectomy1(2.3)
      • View popup
      Table 3

      - Device parameters.

      Vagus nerve stimulator parameters Frequency (n=43)
      VNS Device parameters
      ModelSentiva 100043(100)
      Output current (milliampere)Mean±SD1.78±0.7
      Range0 to 2.7
      Pulse width (microseconds)25043(100)
      On-Time (seconds)3043(100)
      Off-Time (minutes)1.19(20.9)
      3.05(11.6)
      5.029(67.4)
      Frequency (Hertz)2043(100)
      Auto-Stimulations
      Output current ((milliampere)Mean±SD1.35±0.78
      Range0 to 2.75
      Pulse width (microseconds)25043(100)
      Duration (seconds)309(20.9)
      6034(79.1)
      Threshold (percentage)Mean±SD32.60 % (13.07%)
      Range0 to 70 %
      Magnet Stimulations
      Output current ((milliampere)Mean±SD2.00±0.83
      Range0 to 3
      Pulse width (microseconds)2509(20.9)
      50034(79.1)
      Duration (seconds)6043(100)
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    Vagus nerve stimulation in medically refractory epilepsy: Adverse effects and clinical correlates
    Khaled A. Alshehri, Shaima H. Abuhulayqah, Mohammed A. Asiry, Suad A. Alyamani
    Neurosciences Journal Jan 2024, 29 (1) 10-17; DOI: 10.17712/nsj.2024.1.20230006

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    Vagus nerve stimulation in medically refractory epilepsy: Adverse effects and clinical correlates
    Khaled A. Alshehri, Shaima H. Abuhulayqah, Mohammed A. Asiry, Suad A. Alyamani
    Neurosciences Journal Jan 2024, 29 (1) 10-17; DOI: 10.17712/nsj.2024.1.20230006
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