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Clinical Cases and Reviews in Epilepsy

Transauricular Vagus Nerve Stimulation (t-VNS) as a valid predictor of invasive VNS efficacy in drug resistant epilepsy: a case-report

Brief report/Clinical case, 74 - 79
doi: 10.11138/ccre/2017.2.1.074
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Abstract
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Vagus Nerve Stimulation (VNS) is a palliative therapy for patients with drug-resistant epilepsy.
Nonetheless, no predictive factors for efficacy have been identified. Recently, a non-invasive transcutaneous VNS (t-VNS) has been developed.
It stimulates an auricular branch of the vagus nerve directed to the same nuclei of VNS. Here we report the case of a young female patient with drug-resistant epilepsy, caused by a right frontal cortical dysplasia. She had the onset of seizures at the age of 4 months, and she presented with a
West syndrome in the first year of life; in the following years, she had various types of focal seizures, with rare secondary generalization and frequent falls. She had uncountable seizures every day and a severe psychomotor delay. At the age of eight, she underwent surgery, however without benefit. At 13 years, she tested t-VNS with significant seizure reduction. Stable VNS was then implanted. Quality of life, alertness and performances of the patient improved. Even if it needs demonstration in larger case series, t-VNS could
be used to predict the effectiveness of VNS, in order to select the best candidates for a stable implant.

Vol. 2 (No. 1) 2017 Janaury - December

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