Waseem H. Alkhaffaf is currently working in the Department of Medicine and also as Faculty of Medicine at Nineveh University, Mosul, Iraq.
Background: Despite the introduction of new Antiepileptic Drugs (AEDs) and advances in the surgical treatment of epilepsy, an important group of patients still remains uncontrolled by any of these methods. Vagus Nerve Stimulation (VNS) is an adjunctive treatment for those with drug resistant epilepsy. In addition to the reduction in seizure frequency, there is other variables need to be assessed for better determination of VNS efficacy like Quality of Life (QOL) improvement.
Aims of the study: Evaluate the effectiveness of VNS, for Iraqi patients with refractory epilepsy, in reducing seizure frequency and improving QOL of these patients.
Method and Patients: Forty-six patients of drug resistant epilepsy were examined. They underwent implantation of a stimulator in and with a follow-up of three year. The study conducted at medical city in Baghdad/ Iraq at the period between 2016-2020 the patients were 25 male and 21 females, and their ages at VNS implantation was ≥18 year old for 28 patients and between11-17 year old for 18 patients. Analysis of seizure reduction (using McHugh classification) with the effect of demographic and clinical variables on it and assessment of QOL (using QOLIE-35 and QOLIE-AD 48 scales) were done in this study. SSPS v.23 was used for the statistical analysis.
Results: The total well response rate (including class I and II and equal to reduction in seizure frequency ≥50%) was 60.9 % (28/46 patients), 6 cases became seizure free and 5 cases reported no improvement and We also found that the factors of gender, age and predominant seizure type had clinical outcome effects. The mean seizure frequency and number of AEDs that used by the patients reduced. The mean of all domains and overall score of QOL scales improved and some domains had statistically significant improvement.
Conclusion: VNS is a safe, well-tolerated and effective treatment in reducing seizure frequency and improving QOL for patients with drug resistant epilepsy.
Key words: Vagus nerve stimulation, Refractory epilepsy, Quality of life.