Vagus nerve stimulation in people with epilepsy and intellectual disability—English version

Abstract

Background: In view of the still high rate of pharmaco-resistance in epilepsy, it is crucial to shed light on the non-pharmacological forms of therapy. Consideration of the patient group with epilepsy and intellectual disability is important for several reasons: it is a relevant patient group with an even higher proportion of drug-resistant courses than in people with epilepsy and normal intelligence. Resective epilepsy surgery is often not possible due to multifocal or diffuse brain damage. There are specific syndromes to consider as well as cognitive and behavioral peculiarities. Vagus nerve stimulation is discussed as a possible palliative therapy option. Aim of the work: Based on a literature search, the present work sheds light on the importance of vagus nerve stimulation in the treatment of people with epilepsy and mental disabilities with special consideration of specific syndromes. Results: Depending on the syndrome, the nature of the studies and the observational period, different outcomes of vagus nerve stimulation are observed. Compared to people with epilepsy and normal intelligence, there is a similar spectrum of side effects. Discussion: Vagus nerve stimulation may be discussed in people with epilepsy and intellectual disability, bearing in mind the palliative nature of the intervention and the need for implantation of a device. It should be remembered that magnetic resonance imaging can only be used to a limited extent in the presence of an implanted vagus nerve stimulator.