Vagus nerve stimulation (VNS) for the treatment of refractory partial epileptic seizures with or without secondary
generalisation in patients older than 12 years was approved in Europe in 1994 and in the United States in 1997.We have
studied the efficacy of VNS in patients with pharmacoresistant epilepsy hospitalized in the Neurology Department of the
University Hospital Centre Zagreb. From 1997 do 2001 we have implanted VNS in 11 patients with pharmacoresistant
epilepsy, who were magnetic resonance imaging (MRI) negative and from May 2007 to May 2009 in 11 patients with
pharmacoresistant epilepsy, 9 of them were MRI positive, and were inoperable due to localisation of the pathomorphologic
changes (ganglioglioma, hamartoma, various types of cortical dysplasia, porencephalic cysts), 2 were MR negative.
In the group of MRI negative patients 1 patient had complex partial seizures (CPS), 6 patients had CPS with secondary
generalisation, 2 patients had primary generalized epilepsy (PGE) including myoclonic, absence, atonic and tonic-clonic
seizures, one patient had PGE and CPS, and 3 patients had Lennox-Gastaut syndrome (LGS). In the group of MRI positive
patients one patient had elementary partial seizures (EPS) and CPS, two patients had EPS and CPS with secondary
generalisation, one patient had CPS, 3 patients had CPS with secondary generalisation, and 2 patients had CPS with
secondary generalisation as well as atonic seizures. After continuous follow-up of 11 MRI negative patients during 5
years and 2 MRI negative patients during one year there was decrease in mean-seizure frequency of 51.67%. After continuous
follow-up of 9MRI positive patients during 2 years there was decrease in mean-seizure frequency of 61.9 %. The most
frequent side effects were hoarseness, throat pain and cough in the »on phase« of the VNS, but they were mild and transitory.
We can conclude that VNS was effectivemode of therapy in our group of patients with pharmacoresistant epilepsy
