Cited by 683Vagus Nerve Stimulation ResearchEpilepsy research and treatmentDeep Brain Stimulation and Movement Disorders

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Vagus Nerve Stimulation for Treatment of Partial Seizures: 1. A Controlled Study of Effect on Seizures

Ben‐Menachem, E., Mañon‐Espaillat, R., Ristanovic, R., Wilder, B. J., Stefan, H., Mirza, W., Tarver, W. B., Wernicke, J. F., First International Vagus Nerve Stimulation Study Group·1994·Epilepsia

DOI 10.1111/j.1528-1157.1994.tb02482.x

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Abstract

Summary: Vagus nerve stimulation (VNS) was shown to reduce seizure frequency in refractory epilepsy patients in two pilot studies. Based on these results, a multicenter, prospectively randomized, parallel, double‐blind study of patients with refractory partial seizures was initiated. After a 12–week baseline period, identical vagus nerve stimulators were implanted and patients randomized to either a high or low 14–week VNS treatment paradigm. The primary objective was to demonstrate that high VNS (therapeutic parameters) was more effective in reducing partial seizure frequency than was low VNS (less or noneffective parameters). Patients continued receiving antiepileptic drugs (AEDs) with plasma concentrations held constant throughout the study. We report results of the first 67 patients to exit the 14‐week acute phase. After 14 weeks of VNS, 31 patients receiving high VNS experienced a mean seizure frequency percentage reduction of 30.9%, which was statistically significant as compared with the mean seizure frequency percentage reduction of 11.3% in 36 patients receiving low VNS (p = 0.029, t test; p = 0.036, Wilcoxon rank‐sum test). In addition to the significant intra group p‐values, mean seizure frequency percentage change reached statistical significance for high VNS (p < 0.001) but not low VNS (p = 0.072) as compared with baseline. Twelve of 31 (38.7%) patients receiving high VNS achieved at least 50% reduction in seizure frequency whereas 7 of 36 (19.4%) patients receiving low VNS experienced at least 50% reduction after 14 weeks. The implant procedure and VNS therapy were well tolerated. Our study confirmed the effectiveness of VNS as treatment for epilepsy patients with refractorypartial seizures.

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Prevention of Intractable Partial Seizures by Intermittent Vagal Stimulation in Humans: Preliminary Results
Penry, J. K., & Dean, J. C. (1990) · Epilepsia · doi:10.1111/j.1528-1157.1990.tb05848.x · Cited by 474
Inhibition of Experimental Seizures in Canines by Repetitive Vagal Stimulation
Zabara, J. (1992) · Epilepsia · doi:10.1111/j.1528-1157.1992.tb01751.x · Cited by 398
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Woodbury, D. M., & Woodbury, J. W. (1990) · Epilepsia · doi:10.1111/j.1528-1157.1990.tb05852.x · Cited by 369
Anatomical, Physiological, and Theoretical Basis for the Antiepileptic Effect of Vagus Nerve Stimulation
Rutecki, P. A. (1990) · Epilepsia · doi:10.1111/j.1528-1157.1990.tb05843.x · Cited by 341
Vagus Nerve Stimulation for Treatment of Partial Seizures: 2. Safety, Side Effects, and Tolerability
Ramsay, R. E., Uthman, B. M., Augustinsson, L.-E., Upton, A. R. M., Naritoku, D. K., Willis, J. K., Treig, T., Barolat, G., Wernicke, J. F., & First International Vagus Nerve Stimulation Study Group (1994) · Epilepsia · doi:10.1111/j.1528-1157.1994.tb02483.x · Cited by 260
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Vagus Nerve Stimulation for Treatment of Partial Seizures: 3. Long‐Term Follow‐Up on First 67 Patients Exiting a Controlled Study
George, R. E., Salinsky, M., Kuzniecky, R., Rosenfeld, W. E., Bergen, D. C., Tarver, W. B., Wernicke, J. F., & First International Vagus Nerve Stimulation Study Group (1994) · Epilepsia · doi:10.1111/j.1528-1157.1994.tb02484.x · Cited by 197
Self-citation
Feasibility and Safety of Vagal Stimulation In Monkey Model
Lockard, J. S., Congdon, W. C., & DuCharme, L. L. (1990) · Epilepsia · doi:10.1111/j.1528-1157.1990.tb05844.x · Cited by 189
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Research works printed but not linked: 9

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Authors: Ben‐Menachem, E., Mañon‐Espaillat, R., Ristanovic, R., Wilder, B. J., Stefan, H., Mirza, W., Tarver, W. B., Wernicke, J. F., & First International Vagus Nerve Stimulation Study Group
Affiliations: University of Gothenburg (SE)
Rush University Medical Center (US)
Universitätsklinikum Erlangen (DE)
Saint Louis University (US)
Corresponding author: Wernicke, J. F.
Venue: Epilepsia
Publisher: Wiley
Published: 1994-05
Volume: 35
Issue: 3
Pages: 616-626
ISSN: 0013-9580 (ISSN-L)
1528-1167
DOI: 10.1111/j.1528-1157.1994.tb02482.x
OpenAlex: W2022305238
Cited by: 683
References: 22
Citations by year: 2026: 21 · 2025: 31 · 2024: 24 · 2023: 30 · 2022: 28 · 2021: 33 · 2020: 26 · 2019: 21 · 2018: 31 · 2017: 16 · 2016: 27 · 2015: 42 · 2014: 20 · 2013: 35 · 2012: 26
FWCI: 2.88
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4198 d)
Locations: Epilepsia (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
Keywords: vagus nerve stimulation, drug-resistant epilepsy, focal seizures, seizure frequency reduction, high-frequency stimulation, low-frequency stimulation, antiepileptic drugs, implantable neurostimulator, treatment tolerability
MeSH terms: Adolescent, Adult, Aged, Anticonvulsants, Child, Combined Modality Therapy, Double-Blind Method, Electrodes, Implanted, Electric Stimulation Therapy, Epilepsies, Partial, Equipment Design, Female, Follow-Up Studies, Humans, Magnetics, Male, Medical Records, Middle Aged, Prospective Studies, Severity of Illness Index, Vagus Nerve, Treatment Outcome, Prostheses and Implants

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Vagus Nerve Stimulation for Treatment of Partial Seizures: 1. A Controlled Study of Effect on Seizures

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