TY - JOUR
T1 - Stimulation parameters after vagus nerve stimulator replacement
AU - Labar, Douglas
AU - Ponticello, Laura
AU - Nikolov, Blagovest
AU - Bellapu, Sowdhamani
AU - Schwartz, Theodore H.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/4
Y1 - 2008/4
N2 - Objectives. This study aims to assess tolerability and efficacy of stimulation parameters after vagus nerve stimulator (VNS) pulse generator replacement. Materials and Methods. We carried out an observational, retrospective study, reviewing our experience with VNS generator replacements in 28 epilepsy patients. Results. Seven patients had actual end of battery life (EOBL) (with symptoms), and 21 patients had asymptomatic projected EOBL. When we reprogrammed stimulation parameters postoperatively, 17 of the 28 patients could not tolerate the preoperative baseline current settings, even one year later. There were no differences in pre- vs. postoperative seizure rates between patients who did or did not return to baseline settings. Failure to return to baseline current was not related to previous VNS duration, same- vs. different-battery generator replacements, or antiepileptic medication changes. Conclusions. After VNS generator replacement, patients' common inability to tolerate preoperative current settings does not lead to more seizures. A chronic modification of the vagus nerve system's sensitivity to stimulation changes may be hypothesized.
AB - Objectives. This study aims to assess tolerability and efficacy of stimulation parameters after vagus nerve stimulator (VNS) pulse generator replacement. Materials and Methods. We carried out an observational, retrospective study, reviewing our experience with VNS generator replacements in 28 epilepsy patients. Results. Seven patients had actual end of battery life (EOBL) (with symptoms), and 21 patients had asymptomatic projected EOBL. When we reprogrammed stimulation parameters postoperatively, 17 of the 28 patients could not tolerate the preoperative baseline current settings, even one year later. There were no differences in pre- vs. postoperative seizure rates between patients who did or did not return to baseline settings. Failure to return to baseline current was not related to previous VNS duration, same- vs. different-battery generator replacements, or antiepileptic medication changes. Conclusions. After VNS generator replacement, patients' common inability to tolerate preoperative current settings does not lead to more seizures. A chronic modification of the vagus nerve system's sensitivity to stimulation changes may be hypothesized.
KW - Epilepsy
KW - Generator replacement
KW - Stimulation parameters
KW - Vagus nerve stimulation
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U2 - 10.1111/j.1525-1403.2008.00155.x
DO - 10.1111/j.1525-1403.2008.00155.x
M3 - Article
C2 - 22151047
AN - SCOPUS:41749124116
SN - 1094-7159
VL - 11
SP - 132
EP - 134
JO - Neuromodulation
JF - Neuromodulation
IS - 2
ER -