Figure 6. Diagrams illustrating the relationship between Engel Outcome Scale and Hague Seizure Severity Scale in the pediatric population.

The figure demonstrates that improved Engel Outcome Scale (EOS) outcomes are associated with lower Hague Seizure Severity Scale (HASS) scores, reflecting reduced seizure severity in pediatric and cognitively impaired patients. The mixed-effects linear regression model revealed that HASS scores decreased significantly after each surgery, with an average reduction of 5 points after the initial installation (p < 0.001) and further reductions following each revision, highlighting the effectiveness of vagus nerve stimulation (VNS) in reducing seizure severity in the pediatric and cognitively impaired population.