Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox-Gastaut syndrome

Hilde M Braakman; Joke Creemers; Danny M Hilkman; Sylvia Klinkenberg; Suzanne M Koudijs; Mariette Debeij-van Hall; Erwin M Cornips

doi:10.1016/j.ebcr.2018.08.002

Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox-Gastaut syndrome

Epilepsy Behav Case Rep. 2018 Sep 11:10:111-113. doi: 10.1016/j.ebcr.2018.08.002. eCollection 2018.

Authors

Hilde M Braakman¹, Joke Creemers¹, Danny M Hilkman², Sylvia Klinkenberg^{1

2}, Suzanne M Koudijs², Mariette Debeij-van Hall¹, Erwin M Cornips³

Affiliations

¹ Department of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC +, PO Box 61, 5591 VE Heeze, the Netherlands.
² Department of Neurology, Maastricht UMC +, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands.
³ Department of Neurosurgery, Maastricht UMC +, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands.

Abstract

We report a child with Lennox-Gastaut syndrome with an increase in seizure frequency and loss of psychomotor skills due to a disintegrated cervical VNS lead, not detected during standard device monitoring. The lead was completely removed and replaced by a new 303 lead on the same nerve segment. After reinitiating VNS, side effects forced us to switch it off, resulting in immediate seizure recurrence. EEG recording demonstrated a non-convulsive status epilepticus that was halted by reinitiating VNS therapy. Thereafter, he remained seizure free for eight months, and regained psychomotor development.

Keywords: Lennox–Gastaut syndrome; Refractory epilepsy; Revision surgery; Seizure freedom; Vagus nerve stimulation.

Publication types

Case Reports