Evidence map›Paper›PMID 41398533›Full record

Observational studyChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Analysis of the treatment of refractory epilepsy in pediatric patients with Vagus Nerve Stimulation (VNS): A case series.

Jairo Porfírio de Oliveira Júnior, Bárbara Albuquerque Morais, Nayara Matos Pereira, Cilmária Leite Franco, Paulo Ronaldo Jubé Ribeiro

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Beyond seizures: understanding adaptive functioning in drug-resistant epilepsy in patients undergoing palliative surgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jairo Porfírio de Oliveira JúniorDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil. jairopoj@gmail.com.
Bárbara Albuquerque MoraisDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.
Nayara Matos PereiraDivision of Neurosurgery, Children's Hospital of Goiânia, Goiânia, Goiás, Brazil.
Cilmária Leite FrancoDivision of Neurosurgery, Children's Hospital of Goiânia, Goiânia, Goiás, Brazil.
Paulo Ronaldo Jubé RibeiroDivision of Neurosurgery, Department of Surgery, Medical School, Clinics Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDrug-resistant epilepsy (DRE) affects up to 30% of patients with epilepsy, including many children. These patients face a high burden of uncontrolled seizures, frequent hospitalizations, impaired quality of life, and increased risk of sudden unexpected death in epilepsy (SUDEP). For pediatric patients who are not suitable candidates for resective or ablative surgery, neuromodulation strategies such as vagus nerve stimulation (VNS) have emerged as valuable alternatives. Although VNS has demonstrated efficacy in reducing seizure frequency and improving functional outcomes, evidence in pediatric populations-particularly in low- and middle-income settings-remains limited.

objectiveTo assess the clinical outcomes, safety profile, and quality-of-life impact of VNS in pediatric patients with DRE.

methodsA retrospective observational study was conducted involving 21 children with DRE who underwent VNS implantation between November 2021 and December 2024. Data were collected on seizure frequency, hospitalization rates, adverse events, medication use, and caregiver-reported quality of life. Seizure outcomes were evaluated using Engel and McHugh classification systems.

resultsThe mean age at implantation was 7.6 years, with an average follow-up of 17.8 months. A ≥ 50% reduction in seizure frequency was achieved in 85.7% of patients. According to Engel classification, 28.6% achieved Class I, 42.9% Class II, and 23.8% Classes III-IV. Based on the McHugh scale, 76% reached Class I (> 80% reduction), 9.5% Class II (50-80%), and 14.3% Classes III-V (≤ 49% reduction or no improvement). Quality of life was rated ≥ 3 (on a 5-point scale) by 90.4% of caregivers, with 47.6% assigning the highest score. Hospitalizations decreased in 87.5% of cases, and 28% required fewer anti-seizure medications. Reported adverse effects (57.1%) were mild and transient. No deaths occurred.

conclusionVNS is a safe and effective therapeutic option for children with DRE, resulting in significant seizure reduction, improved quality of life, and reduced hospital burden. Larger prospective studies are warranted to refine patient selection and optimize stimulation strategies.

Indexed as

Drug Resistant EpilepsyVagus Nerve StimulationAdolescentChildChild, PreschoolFemaleHumansMaleQuality of LifeRetrospective StudiesTreatment OutcomeDrug-resistant epilepsyNeuromodulationPediatric epilepsyQuality of lifeSeizure outcomeVagus nerve stimulation

Identifiers

PMID41398533

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.