Beneficial effects on sleep of vagus nerve stimulation in children with therapy resistant epilepsy.

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Beneficial effects on sleep of vagus nerve stimulation in children with therapy resistant epilepsy. / Hallböök, Tove; Lundgren, Johan; Köhler, Sven; Blennow, Gösta; Strömblad, Lars-Göran; Rosén, Ingmar.

In: European Journal of Paediatric Neurology, Vol. 9, No. 6, 2005, p. 399-407.

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Hallböök, Tove ; Lundgren, Johan ; Köhler, Sven ; Blennow, Gösta ; Strömblad, Lars-Göran ; Rosén, Ingmar. / Beneficial effects on sleep of vagus nerve stimulation in children with therapy resistant epilepsy. In: European Journal of Paediatric Neurology. 2005 ; Vol. 9, No. 6. pp. 399-407.

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TY - JOUR

T1 - Beneficial effects on sleep of vagus nerve stimulation in children with therapy resistant epilepsy.

AU - Hallböök, Tove

AU - Lundgren, Johan

AU - Köhler, Sven

AU - Blennow, Gösta

AU - Strömblad, Lars-Göran

AU - Rosén, Ingmar

PY - 2005

Y1 - 2005

N2 - The study purpose was to evaluate sleep structure following Vagus Nerve Stimulation (VNS) in 15 children with therapy resistant epilepsy and to correlate possible alterations with changes in epileptiform activity and clinical effects. Fifteen children were examined with ambulatory polysomnographic recordings initially, and after 3 and 9 months of VNS-treatment. Sleep parameters, all-night delta power activity and movement times (MTs), used to account for arousals were estimated. Epileptiform activity was evaluated by spike detection. Seizure frequency was recorded in a diary. The severity of the seizures was scored with the National Hospital Seizure Severity Scale (NHS3). Quality of life (QOL) was assessed by a visual analogue scale. Behaviour problems were quantified by using the total score of the Child Behaviour Checklist (CBCL). VNS induces a significant increase in slow wave sleep (SWS) and a decrease in sleep latency and in stage 1 sleep. The number and density of MTs during total night sleep were significantly increased. There was also a significant increase in the number of MTs immediately related to the VNS stimulation periods. Of the 14 children with increased MTs, 10 had a reduction in epileptiform activity, and in clinical seizures, all had an improvement in NHS3, and 11 in QOL. Of the 10 children with increased SWS, eight also improved in QOL and eight in behaviour. Our findings indicate that VNS counteracts known adverse effects of epilepsy on sleep and increases slow wave sleep. This possibly contributes to the reported improvement in well-being. We also see an increase in MTs. This arousal effect seems to be of minor importance for QOL and could possibly be related to the antiepileptic mechanisms in VNS.

AB - The study purpose was to evaluate sleep structure following Vagus Nerve Stimulation (VNS) in 15 children with therapy resistant epilepsy and to correlate possible alterations with changes in epileptiform activity and clinical effects. Fifteen children were examined with ambulatory polysomnographic recordings initially, and after 3 and 9 months of VNS-treatment. Sleep parameters, all-night delta power activity and movement times (MTs), used to account for arousals were estimated. Epileptiform activity was evaluated by spike detection. Seizure frequency was recorded in a diary. The severity of the seizures was scored with the National Hospital Seizure Severity Scale (NHS3). Quality of life (QOL) was assessed by a visual analogue scale. Behaviour problems were quantified by using the total score of the Child Behaviour Checklist (CBCL). VNS induces a significant increase in slow wave sleep (SWS) and a decrease in sleep latency and in stage 1 sleep. The number and density of MTs during total night sleep were significantly increased. There was also a significant increase in the number of MTs immediately related to the VNS stimulation periods. Of the 14 children with increased MTs, 10 had a reduction in epileptiform activity, and in clinical seizures, all had an improvement in NHS3, and 11 in QOL. Of the 10 children with increased SWS, eight also improved in QOL and eight in behaviour. Our findings indicate that VNS counteracts known adverse effects of epilepsy on sleep and increases slow wave sleep. This possibly contributes to the reported improvement in well-being. We also see an increase in MTs. This arousal effect seems to be of minor importance for QOL and could possibly be related to the antiepileptic mechanisms in VNS.

KW - vagus nerve stimulation

KW - sleep

KW - slow wave sleep

KW - delta power

KW - behaviour

KW - arousal

KW - quality of life

KW - children

KW - epilepsy

U2 - 10.1016/j.ejpn.2005.08.004

DO - 10.1016/j.ejpn.2005.08.004

M3 - Article

VL - 9

SP - 399

EP - 407

JO - European Journal of Paediatric Neurology

JF - European Journal of Paediatric Neurology

SN - 1090-3798

IS - 6

ER -