doi:10.1016/j.ejpn.2008.05.004 
Copyright © 2008 European Paediatric Neurology Society Published by Elsevier Ltd.
Case study
Vagus nerve stimulation for refractory status epilepticus
Veerle De Herdta, 
, 
, Liesbeth Waterschoota, Kristl Voncka, Bart Dermauta, Helene Verhelstb, Rudy Van Costerb, Annick De Jaegerc, Dirk Van Roostd and Paul Boona
aDepartment of Neurology, Reference Center for Refractory Epilepsy, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium
bDepartment of Pediatrics, Division of Pediatric Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium
cIntensive Care Unit, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium
dDepartment of Neurosurgery, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium
Received 13 November 2007;
revised 18 February 2008;
accepted 8 May 2008.
Available online 27 June 2008.
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Abstract
We report on the long-term follow-up of a patient with refractory non-convulsive SE who was successfully treated with VNS. A 7-year old girl with a medical history of thrombosis in the right internal cerebral vein and right thalamic bleeding 8 days after birth, developed epilepsy at the age of 13 months. At the age of 6 she presented with a refractory non-convulsive SE. A vagus nerve stimulator was placed after 11 days of thiopental-induced coma. Three days after VNS implantation, the thiopental-induced coma was successfully withdrawn and electroencephalography showed normalization one week after start of VNS. After a follow-up of 13 months she remains seizure-free and AEDs have been partially tapered. This case illustrates a potential acute abortive effect with sustained long-term seizure reduction of VNS in a 7-year old girl who presented with refractory non-convulsive SE.
Keywords: Vagus nerve stimulation; Non-convulsive status epilepticus; Refractory status epilepticus; Children
Fig. 1. (a) EEG on hospital admission (May 2006, 9 electrodes, bipolar montage) showed 3 Hz generalized spike and wave discharges, (b) EEG after induction of thiopental coma (May 2006, 9 electrodes, bipolar montage) showed a burst-suppression pattern with the bursts still displaying epileptiform activity, (c) EEG a few days after start of VNS (June 2006, 9 electrodes, bipolar montage) showed a reappearance of a background activity of 5–6 Hz mixed with sharp slow waves, but without spike and wave discharges, (d) EEG one year after SE (June 2007, 21 electrodes, bipolar montage) showed a background activity of 7 Hz with diffuse theta activity.
Table 1.
Overview of previously reported patients treated with VNS for SE
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