Abstract Details

Title Impact of VNS Placement on Seizure-Related Emergency Department Visits at 1, 2, and 3 Years Post-Implantation

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P5 - Poster Session 5 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-013

Objective This study evaluates the effect of VNS implantation on seizure-related emergency department (ED) visit frequency at one, two, and three years post-implantation.

Background Drug-resistant epilepsy, defined as the failure of two or more anti-epileptic medications to control seizures, presents substantial treatment challenges. Among neuro-modulating devices, vagal nerve stimulation (VNS) is thought to impact cortical activity by projecting from the nucleus tractus solitarius to brainstem nuclei and cortex. VNS was FDA-approved since 1997.

Design/Methods A single-center retrospective study analyzed 128 epilepsy patients with VNS devices implanted between 2010 and 2023. After excluding 70 patients due to missing data, lack of follow-up, or concurrent treatments, 58 patients remained. ED visits one year pre-implantation were compared with visits at one, two, and three years post-implantation using the Wilcoxon signed-rank test (p<0.05). Descriptive analyses of quantitative and categorical data were also conducted.

Results The mean age of epilepsy onset was 16.5 years, with females comprising 50% of the study group. The median age at VNS implantation was 36 years, and the median number of medications was three. Seizure types included generalized onset (41%), focal onset (22.4%), and both (6.9%). No significant reduction in ED visits was observed in the first (p=0.24) and second years (p=0.06) post-implantation compared to baseline. However, a significant reduction was noted by the third year (p=0.049). Among patients with two or more pre-implantation ED visits, most showed improvement post-implantation.

Conclusions Although ED visits did not significantly decrease in the first two years post-VNS implantation, a notable reduction was seen by the third year. Absence of ED visits in some patients suggests possible follow-up gaps. Study limitations include incomplete documentation of patients treated in other health systems and significant loss to follow-up, affecting study power. Future research should explore VNS parameters, age of onset, and long-term follow-up, particularly since VNS devices now include auto-stimulation functions.

Authors/Disclosures
Gurleen Kaur, MD (Allegheny General Hospital) PRESENTER	Dr. Kaur has nothing to disclose.
Sahil Sardana, MD	Dr. Sardana has nothing to disclose.
Muhammad Saim	Mr. Saim has nothing to disclose.
Praveer Vyas, MPH	Mr. Vyas has nothing to disclose.
Dorian M. Kusyk, MD	Dr. Kusyk has nothing to disclose.
Alexander Whiting	Alexander Whiting has nothing to disclose.

��ɫ��

��ɫ��