SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Factors predicting the response to vagus nerve stimulation (VNS) in pediatric patients with drug- resistant epilepsy: a systematic review and meta-analysis.
Synthesis 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. Not yet cited in PubMed.
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Abstract
objectiveVagus Nerve Stimulation (VNS) has been found to significantly reducses seizure frequency in both generalised and focal epilepsy of various aetiologies, however its benefits in the paediatric population are less well understood. Hence, this systematic review and meta-analysis aims to critically evaluate the effectiveness of VNS in children, and identify potential prognostic factors for patient selection.
methodsA comprehensive literature search was performed on PubMed, Embase and Medline for full-text articles up until 25th June 2025, according to the PRISMA 2020 statement (PROSPERO CRD42024610201). A random-effects meta-analysis was performed to estimate the pooled effect of VNS on % Significant Seizure Reduction (%SSR), defined as the percentage of patients achieving > 50% seizure reduction at least 3-months after VNS implantation. Subgroup analyses and meta-regression were used to explore predictors of treatment response.
resultsA total of 1863 articles were identified, of which 47 were included, involving 1685 patients. Overall, %SSR post-VNS was 55% (95% CI:51%-59%, I
conclusionVNS is an effective treatment for paediatric drug-resistant epilepsy when surgical resection is not possible. %SSR following VNS was significantly associated with both stimulation amplitude, a modifiable treatment parameter, and age at seizure onset, a non-modifiable patient characteristic. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024610201.
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