The efficacy and safety of vagus nerve stimulation in pediatric epilepsy in China: a multicenter cohort study

Background The field of epilepsy neural regulation represented by VNS is rapidly developing. Our aim was to investigate the safety and effectiveness of vagus nerve stimulation (VNS) as an adjunct therapy for pediatric epilepsy in a multi-center study across China. Methods Children with epilepsy undergoing VNS as supplementary treatment were consecutively enrolled in this study. Eligibility was limited to children aged 1–16 years with a confirmed epilepsy diagnosis, a stable antiseizure medication regimen, and a minimum of two seizures per 28-day cycle during the 8-week retrospective baseline. Results Eighty-seven children (54 males; mean age 8.21 ± 3.88 years, range 0–16) were included, with seizures beginning at an average age of 3.03 ± 2.90 years. A ≥ 50% reduction in seizure frequency was observed in 23.7% at 6 weeks, 20.3% at 10 weeks, 22.6% at 18 weeks, and 18.6% at 26 weeks. Seizure freedom was achieved in 17.1%, 15.9%, 11.3%, and 16.3% of patients at the same intervals. Two subjects experienced adverse events, both of which were mild and transient. Conclusions VNS demonstrated moderate efficacy and a favorable safety profile as an adjunct treatment in children with epilepsy. Further large-scale, long-term studies are recommended to confirm these findings.