Table 1.
Reviewed patients and our case. Onset, epileptic seizure onset; VNS, vagus nerve stimulation; CPS, complex partial seizure; GTC, generalized tonic–clonic seizure; sGTC, secondary GTC; LOC, loss of consciousness; n.a, not available; ASD, anti-epilepsy drug; LEV, levetiracetam; PER, perampanel; CBZ, carbamazepine; OXC, oxcarbazepine; LTG, lamotrigine; CLB, clobazam; CLZ, clonazepam; PB, phenobarbital; PRM, primidone; VPA, valproate; TPM, topiramate; PHT, phenytoin; FMB, felbamate; BZP, benzodiazepine; GBP, gabapentin; ZNS, zonisamide; DM, diabetes mellitus; AV block, atrioventricular block.
| Author | Age [years] | Sex | Onset [years] | Age at VNS [years] | Main seizure | VNS induced symptoms | VNS output | Duty cycle | AED | Other medication | Concomitant symptoms | VNS |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tatum 1999 | 38 | F | n.a | 38 | CPS | n.a | 1 mA | n.a | PHT/lorazepam/tiagabine | n.a | Anxiety | Deactivation |
| 57 | M | n.a | 57 | Partial seizure | n.a | 1 mA | n.a | LTG/PRM | Olanzapine/sertraline | Encephalopathy/depression/alcohol abuse/ | Deactivation | |
| 38 | M | n.a | 38 | Partial seizure | n.a | 1 mA | n.a | CBZ/VPA/vigabatrin | n.a | Left encephalomalacia | Deactivation | |
| 42 | M | n.a | 42 | Partial seizure | n.a | > 1 mA | n.a | TPM/FMB/PHT/PB | Trifluoperazine | Encephalopathy/multiple handicaps/autism | Dose decreased | |
| Asconape 1999 | 56 | M | n.a | 56 | CPS | n.a | 1 mA | n.a | LTG/PRM | Olanzapine/sertraline | Encephalopathy/pulmonary disease/hypertension | Deactivation |
| Ali 2004 | 53 | M | 4 | 53 | GTC/atypical absence | n.a | 1 mA | n.a | CBZ/VPA | n.a | Encephalopathy | Deactivation |
| 40 | M | n.a | 40 | GTC/CPS/myoclonus | n.a | 1 mA | n.a | CBZ/VPA | n.a | Encephalopathy | Deactivation | |
| 42 | F | n.a | 42 | CPS | n.a | 1.25 mA | n.a | GBP/CZP | DM/vasodilator | Diabetes/hypertension/1st degree AV block | Dose decreased | |
| Srinivasan 2004 | 40 | F | n.a | 40 | Partial seizure | Nausea/vomiting/lightheadedness/palpitation | n.a | n.a | n.a | n.a | n.a | Continued |
| Adresh 2007 | 32 | F | 14 | 32 | CPS | n.a | 1 mA | n.a | OXC/FMB | n.a | n.a | Continued |
| 52 | M | n.a | 52 | Partial seizure | n.a | 1 mA | n.a | PHT/TPM | n.a | Depression/1st-degree AV block | Continued | |
| 59 | F | 2 | 59 | GTC | n.a | 1 mA | n.a | CBZ/VPA/CLB | n.a | Bitemporal sclerosis | Continued | |
| Koeing 2008 | 8 | F | 3 m | 8 | Multiple types | Improved | n.a | n.a | VPA/FMB/BZP | n.a | Respiratory sinus arrhythmia | Continued |
| Amark 2008 | 17 | M | 5 m | 15 | CPS | Sudden LOC uncontrollable fall | 1.75 mA | 10% | VPA/GBP/acetazolamide | n.a | n.a | Deactivation |
| Borusiak 2009 | 13 | M | 5 | 7 | CPS without sGTC | Significant increase in seizure frequency | 2.25 mA | 10% | PB/FMB/ZNS | Calcium/vitamin D | n.a | Deactivation |
| Irarte 2009 | 47 | F | 12 | 38 | CPS/status epilepticus | New events of dizziness, unsteadiness | 1.75 mA | 10% | PGB/CZP/LEV | n.a | Psychogenic non-epileptic spell | Deactivation |
| Clark 2012 | 13 | M | 2 | 2 | GTC | Syncope/obtundation | 1.25 mA | 8% | CZP/ZNS/RFM | n.a | Septo-optic dysplasia | Revision/continued |
| Shanker 2013 | 55 | M | n.a | 47 | Partial seizure/sGTC/drop attack | Sudden increase in frequency of atonic spells | 2.25 mA | 16% | LEV/PGB | n.a | Encephalopathy/cerebral anoxic brain | Deactivation |
| Schevchuck 2014 | 40 | M | n.a | 39 | CPS without sGTC | New type of seizure | n.a | 10% | LCM/LTG/LEV/PGB | Encephalopathy | Continued | |
| Cantarin 2016 | 13 | F | 2 | 3 | Drop attack/myoclonus | New attack with sudden fall/LOC | 1.25 mA | 10% | VPA | n.a | n.a | Dose decreased |
| Pascual 2015 | 56 | M | 9 | 42 | CPS | Syncope/lightheadedness/LOC | 2.75 mA | 12% | LEV/TPM | Alprazolam | Anxiety | Deactivation |
| Our case | 47 | M | 27 | 37 | CPS | Sudden LOC with uncontrollable fall | 1.75 mA | 10% | LEV/CBZ | Risperidone | Epileptic psychiatric disorder | Continued with pacemaker |
F, female; M, male; m, months; Onset, epileptic seizure onset; VNS, vagus nerve stimulation; CPS, complex partial seizure focal impaired awareness seizure; GTC, generalized tonic–clonic seizure; sGTC, secondary GTC (focal to bilateral tonic-clonic seizure); LOC, loss of consciousness; n.a, not available; AED, anti-epilepsy drug; LEV, levetiracetam; PER, perampanel; CBZ, carbamazepine; OXC, oxcarbazepine; LTG, lamotrigine; CLB, clobazam; CLZ, clonazepam; PB, phenobarbital; PRM, primidone; VPA, valproate; TPM, topiramate; PHT, phenytoin; FMB, felbamate; BZP, benzodiazepine; GBP, gabapentin; ZNS, zonisamide; DM, diabetes mellitus; A-V block, atrioventricular block.