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目的 :总结迷走神经刺激术 (VNS)对顽固性癫的疗效及评价其临床应用的价值。方法 :用VNS治疗 7例顽固性癫患者 ,治疗期为 3年 ,结束治疗后继续观察 2年 ,共观察 5年。整个观察期内患者仍用足量抗癫药物。比较治疗前、治疗期及结束治疗后癫的发作情况及EEG变化。结果 :7例患者在VNS治疗期内 5例有效 ,其中 3例发作频率减少 2 5 %～ 5 0 % ,2例终止发作 ,另 2例无效。结束VNS治疗后原有效的 3例中 ,2例发作加重 ,1例发作类型改变 ,发作次数增加 ,但强度减轻 ;2例终止发作者中 1例目前仍未发作 ,另 1例癫复发。EEG情况与临床相一致 ,当癫发作被控制时 ,EEG明显好转 ,棘 (尖 )慢复合波减少。癫复发时EEG会出现相应的样放电。 7例患者在结束随访的第五年 ,有 6例EEG仍明显异常 ,有棘 (尖 )或棘 (尖 )慢复合波。结论 :VNS治疗顽固性癫具有安全性 ,且治疗期间有一定的疗效 ,但由于其对发作的完全控制率低 ,停止刺激后易复发 ,且费用昂贵 ,很难作为一种令人满意的治疗方法
Objective: To summarize the curative effect of vagus nerve stimulation (VNS) on intractable epilepsy and to evaluate its clinical value. Methods: Seven patients with intractable epilepsy were treated with VNS. The treatment period was 3 years. After the end of treatment, they were observed for 2 years and observed for 5 years. Patients were still given adequate anti-epileptic drugs throughout the observation period. Epileptic seizures and EEG changes were compared before, during and after treatment. Results: Seven patients were effective in 5 cases during the VNS treatment. The frequency of seizure decreased from 25% to 50% in 3 cases, termination of attack in 2 cases and invalid in 2 cases. Of the 3 patients who were effective after the end of VNS treatment, 2 patients had exacerbations, 1 patient had seizure type change, seizure frequency increased, but intensity decreased; 1 patient had no seizures in 2 patients and another had epilepsy recurrence. The EEG situation is consistent with the clinical situation. When the epileptic seizure is controlled, the EEG obviously improves and the spina (sharp) slow recombination wave decreases. Epileptic EEG recurrence occurs when the corresponding sample discharge. During the fifth year of follow-up, six patients with EEG were still significantly abnormal in seven patients, with spina (sharp) or spina (slow) complex waves. CONCLUSIONS: VNS is a safe treatment for intractable epilepsy and has some efficacy during treatment, but it is difficult to treat VNS as a satisfactory treatment because of its low rate of complete control of the episode, its relapse after stopping the stimulus and its high cost treatment method