We implanted a VNS device after more than two months from SRSE onset and multiple therapeutic attempts in a patient with Lafora disease and recurrent SE. We performed a very rapid stimulation parameter titration, without apparent side effects. We managed to withdraw anaesthetics 24 hours after reaching an assumed therapeutic setting. Therefore, according to the proposed efficacy criteria in SE [6], we assumed that the VNS implant was responsible for the SRSE interruption. No further SE nor GTCS occurred over the following nine months. The outcome on consciousness, however, was dismal, probably due both to the long duration of the status and of anaesthetic treatment and to the severity of the underlying disease. This was the first and sole VNS implantation acutely performed in our Centre for a RSE. Although this is a single case, our results support considering VNS acute implantation soon in the course of this condition, with the dual purpose of interrupting the status and preventing its recurrence
Mostacci B., Bisulli F., Muccioli L., Minardi I., Bandini M., Licchetta L., et al. (2019). Super refractory status epilepticus in Lafora disease interrupted by vagus nerve stimulation: A case report. BRAIN STIMULATION, 12(6), 1605-1607 [10.1016/j.brs.2019.08.008].
Super refractory status epilepticus in Lafora disease interrupted by vagus nerve stimulation: A case report
Bisulli F.;Muccioli L.;Licchetta L.;Zanello M.;Tinuper P.
2019
Abstract
We implanted a VNS device after more than two months from SRSE onset and multiple therapeutic attempts in a patient with Lafora disease and recurrent SE. We performed a very rapid stimulation parameter titration, without apparent side effects. We managed to withdraw anaesthetics 24 hours after reaching an assumed therapeutic setting. Therefore, according to the proposed efficacy criteria in SE [6], we assumed that the VNS implant was responsible for the SRSE interruption. No further SE nor GTCS occurred over the following nine months. The outcome on consciousness, however, was dismal, probably due both to the long duration of the status and of anaesthetic treatment and to the severity of the underlying disease. This was the first and sole VNS implantation acutely performed in our Centre for a RSE. Although this is a single case, our results support considering VNS acute implantation soon in the course of this condition, with the dual purpose of interrupting the status and preventing its recurrenceI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
