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Abstract Details

Is there a difference in reduction of seizure frequency between transcutaneous and traditional VNS?
Epilepsy/Clinical Neurophysiology (EEG)
P5 - Poster Session 5 (11:45 AM-12:45 PM)
Transcutaneous vagus nerve stimulation (t-VNS) aims to overcome the disadvantages of surgical implantation of traditional VNS, yet little is known about whether these modalities are equally effective in seizure frequency reduction.

Our aim was to compare seizure frequency reduction between traditional and t-VNS

We conducted a systematic review following the PRISMA guidelines. Included were clinical and/or randomized trial articles indexed by Embase and Pubmed, with the keywords: “drug-resistant epilepsy” or “refractory epilepsy” and “vagus nerve stimulator”. We performed a meta-analysis, considering treatment success as ≥ 50% of seizure frequency reduction. Statistical analyses were weighted for population size. We performed Mann-Whitney test for between-group and Wilcoxon test for within-group analyses.

Eighteen studies were included (13 traditional, 5 t-VNS), with a total of 1383 patients, with a mean age of 31.27 ± 8.71 years and median follow-up assessment of 12 months (range, 3.5–36). The median success rate for the traditional and t-VNS groups were 49.2% (range, 28–100) and 28% (range, 0–54), respectively (P < 0.0001), with adherence >70% to t-VNS. High variability was observed within the traditional VNS studies (P=0.002), but not in t-VNS. The most common reported side effects from t-VNS were ear pain, dizziness, and headache while traditional VNS was most associated with cough and dysphonia. 

Although t-VNS presents as a more convenient alternative to its traditionally implanted counterpart, its efficacy seems to be relatively low for refractory epilepsy. Furthermore, t-VNS has been associated with more frequently reported side effects than traditional VNS.
Jonadab Dos Santos Silva (Icahn School of Medicine at Mount Sinai)
Mr. Dos Santos Silva has nothing to disclose.
Caio Pluvier Duarte Costa (Federal Fluminense University) Mr. Costa has nothing to disclose.
Henrique Jannuzzelli Prado, MD No disclosure on file
Isabella D'Andrea Meira No disclosure on file