epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333.2019.11.1.27-36epilepsia-454Research ArticleORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИEfficacy and safety of vagal nerve stimulation in patients with pharmacoresistant epilepsyЭффективность и безопасность стимуляции блуждающего нерва у пациентов, страдающих фармакорезистентной эпилепсиейhttps://orcid.org/0000-0003-4639-6365АрешкинаИ. Г.AreshkinaI. G.

ассистент кафедры медицинской генетики и клинической нейрофизиологии ИПО, врач-невролог

Author ID (SCOPUS) 55413907300

ул. Партизана Железняка, д. 1, Красноярск 660022, Россия

MD, PhD Student, Assistant at the Department of Medical Genetics and Clinical Neurophysiology, IPO

Author ID (SCOPUS) 55413907300

1 Partizana Zheleznyaka Str., Krasnoyarsk 660022, Russia

strotskaya1992@mail.ruДмитренкоД. В.DmitrenkoD. V.

д. м.н., руководитель Неврологического центра эпилептологии, нейрогенетики Университетской клиники, заведующая кафедрой медицинской генетики и клинической нейрофизиологии

ул. Партизана Железняка, д. 1, Красноярск 660022, Россия

MD, PhD, Head of the Neurological Center for Epileptology and Neurogenetics, University Hospital; Head of the Department of Medical Genetics and Clinical Neurophysiology, IPO

1 Partizana Zheleznyaka Str., Krasnoyarsk 660022, Russia

mart2802@yandex.ruhttps://orcid.org/0000-0002-2840-837XШнайдерН. А.ShnayderN. A.

д. м.н., профессор, ведущий научный сотрудник отделения персонализированной психиатрии и неврологии

Elibrary ID: 185359; SPIN-код: 6517-0279; Researcher ID: M-7084-2014; Scopus ID: 24503222300

ул. Бехтерева, д. 3, г. Санкт Петербург, 192019, Россия

MD, PhD, Professor, Leading Scientific Officer, Department of Neurology and Personal Psychiatric Care

Elibrary ID: 185359; SPIN-код: 6517-0279; Researcher ID: M-7084-2014; Scopus ID: 24503222300

3 Bechterev Str., St Petersburg, 192019, Russia

naschnaider@yandex.ruhttps://orcid.org/0000-0002-6184-9206НародоваЕ. А.NarodovaE. A.

к. м.н., ассистент кафедры нервных болезней с курсом медицинскойреабилитации ПО

Scopus ID: 57203353014

ул. Партизана Железняка, д. 1, Красноярск 660022, Россия

MD, PhD, Assistant at the Department of Nervous Diseases and Medical Rehabilitation

Scopus ID: 57203353014

1 Partizana Zheleznyaka Str., Krasnoyarsk 660022, Russia

katya_n2001@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет им. проф. В. Ф. Войно-Ясенецкого»РоссияVoino-Yasenetskii Krasnoyarsk State Medical UniversityRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр психиатрии и неврологии имени В. М. Бехтерева»РоссияBechterev National Medical Research Center of Psychiatry and NeurologyRussian Federation2019260420191112736Copyright © Areshkina I.G., Dmitrenko D.V., Shnayder N.A., Narodova E.A., 20192019Арешкина И.Г., Дмитренко Д.В., Шнайдер Н.А., Народова Е.А.Areshkina I.G., Dmitrenko D.V., Shnayder N.A., Narodova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/454

Stimulation of the vagal nerve is an effective treatment option in patients with pharmacoresistant epilepsy. Objective: to analyze the efficacy and safety of the Vagal Nerve Stimulation (VNS) procedure in patients suffering from pharmacoresistant epilepsy. Materials and Methods: The study included 13 patients with pharmacoresistant epilepsy, aged 5 to 38 years. Results: among these patients, 25% reported a decrease in the number of epileptic seizures within one-month time after the first session of VNS. The efficacy of the treatment improved with a prolonged use of the VNS-therapy. Despite the long duration of the current pharmacoresistant form of epilepsy in most patients, a decrease in the severity of epileptic seizures and post-seizure disorientation was noted. Side effects of VNS-therapy were recorded in 38.5% of patients; in those, a correction of VNS parameters was performed. This approach allowed us to maintain the effective VNS-therapy and correct the arising side effects. Conclusion: vagal stimulation is an effective non-pharmacological option in patients with pharmacoresistant therapy who have contraindications for surgical treatment. The VNS-therapy reduces the occurrence rate of epileptic seizures by >50% in 20-50% of patients. The VNS therapy has a good long-term efficacy in patients of any age. Stimulation of the vagal nerve is usually well tolerated.

Стимуляция блуждающего нерва является эффективным немедикаментозным методом лечения у пациентов с фармакорезистентной терапией. Цель исследования – проанализировать эффективность и безопасность стимуляции блуждающего нерва у пациентов, страдающих фармакорезистентной эпилепсией. Материалы и методы. В исследование включено 13 пациентов, страдающих фармакорезистентной эпилепсией, в возрасте от 5 до 38 лет. Проведен обзор доступных источников отечественной и зарубежной литературы. Результаты. Четверть пациентов отмечали снижение числа эпилептических приступов уже в первый месяц после первичной настройки стимулятора блуждающего нерва. Эффективность лечения улучшалась при длительном использовании стимуляции блуждающего нерва (VNS-терапия). Несмотря на значительную продолжительность течения фармакорезистентной эпилепсии, выявлено снижение тяжести эпилептических приступов и уменьшение продолжительности постприступной дезориентации. Побочные эффекты VNS-терапии зарегистрированы у 38,5% пациентов, для купирования побочных эффектов производилась коррекция параметров работы стимулятора блуждающего нерва. Это позволило продолжить эффективную VNS-терапию и скорректировать развившиеся побочные эффекты. Заключение. Стимуляция блуждающего нерва – это эффективный нефармакологический вариант лечения у пациентов с фармакорезистентной терапией, которые не могут быть кандидатами для хирургического лечения. VNS-терапия снижает частоту эпилептических приступов более чем на 50% у 20-50% пациентов. VNS-терапия имеет долгосрочную эффективность у пациентов любого возраста. Стимуляция блуждающего нерва, как правило, хорошо переносится.

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The authors declare that there are no conflicts of interest present.