1- Department of Neurophysiology, Ministry of Health, Babylon, Iraq 2- Department of Physiology, Faculty of Medicine, University of Kufa, Kufa, Iraq
* Corresponding Author Address: University of Kufa, P.O Box 21, Kufa, Najaf Governorate, Iraq. Postal Code: 54001 (surae.husseini@student.uokufa.edu.iq)
Abstract (66 Views)
Aims: This study aimed to assess the short-term efficacy of transcutaneous vagus nerve stimulation compared with implanted vagus nerve stimulation in reducing epileptic discharges using long-term video electroencephalography. Materials & Methods:This prospective, comparative study included 30 patients clinically diagnosed with refractory epilepsy. The sample was divided into two groups: Group 1 included 15 patients who received transcutaneous vagus nerve stimulation, and group 2 included 15 patients who received implanted vagus nerve stimulation. Participants in groups 1 and 2 were matched for age, gender, residence, occupation, educational level, and clinical criteria. Patients in both groups underwent long-term video electroencephalography at baseline and 3 months after the intervention. Findings:Mean age was 28.3±8.1 years with transcutaneous vagus nerve stimulation and 29.1±10.8 with implanted vagus nerve stimulation, with no significant demographic differences. Weekly seizures decreased from 28.9 to 9.4 with transcutaneous vagus nerve stimulation and 5.2 to 0.9 with implanted vagus nerve stimulation; absolute reductions differed significantly (19.5 vs. 4.3; p=0.038), but percentage reductions did not (68.1% vs. 82.5%; p=0.17). Adjusted post-treatment frequencies were 8.5±2.0 and 1.2±2.0 seizures/week, respectively (p=0.044). Electroencephalography normalization occurred in 20.0% with transcutaneous vagus nerve stimulation and 73.3% with implanted vagus nerve stimulation (p=0.023); seizure duration decreased in 86.7% and 93.3%, respectively (p=0.540). Conclusion:In patients with refractory epilepsy, a short course of stimulation using an implantable vagus nerve device appears to be more effective in achieving electroencephalography normalization than stimulation delivered transcutaneously.