Surgery Offers Survival Benefit for Pediatric Drug-Resistant Epilepsy

The hazard ratio for overall death reduced with vagus nerve stimulation or cranial epilepsy surgery vs antiseizure meds only.

HealthDay News For pediatric patients with drug-resistant epilepsy, vagus nerve stimulation (VNS) or cranial epilepsy surgery offers a survival benefit compared with antiseizure medications only, according to a study published online June 2 in The Lancet Child & Adolescent Health.

Lu Zhang, Ph.D., from the McGaw Medical Center of Northwestern University in Chicago, and colleagues conducted an observational cohort study involving pediatric patients who were diagnosed with drug-resistant epilepsy to compare long-term survival rates associated with antiseizure medications only (10,240 patients; median age, 7 years), antiseizure medications plus VNS (5,019 patients; median age, 9 years), and antiseizure medications plus cranial epilepsy surgery (3,033 patients; median age, 9 years). Patients in the medical therapy cohort were treated with at least 3 antiseizure medications.

Researchers found that the inverse probability of treatment weighting (IPTW)-adjusted probabilities of surviving beyond 10 years were 89.27, 92.65, and 98.45% for the medical therapy cohort, the VNS cohort, and the surgery cohort, respectively, with a significant difference observed in survival probabilities. The IPTW-adjusted hazard ratio for overall death was 0.60 and 0.19 for the VNS and surgery cohorts, respectively, compared with the medical therapy cohort.

“These findings suggest a mortality benefit with surgical treatments in pediatric patients with drug-resistant epilepsy and point to the importance of multidisciplinary diagnostic and treatment approaches for these patients, such as those offered at comprehensive epilepsy centers where surgery is a part of the treatment options for epilepsy,” the authors write.

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