{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:51:18Z","timestamp":1781776278660,"version":"3.54.5"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate clinical outcomes, treatment response and predictors of seizure freedom after vagus nerve stimulation in patients with drug\u2010resistant epilepsy in a Mexican cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter cohort across 13 epilepsy centers in Mexico (2003\u20132024) including patients aged \u22654\u2009years with drug\u2010resistant epilepsy or epileptic encephalopathy. Treatment response was defined as at least 50% seizure reduction and Engel outcomes. Logistic regression identified predictors of seizure freedom. Model performance was assessed with receiver operating characteristic analysis, area under the curve, Hosmer\u2013Lemeshow test, and a confusion matrix.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010three patients (51 children, 42 adults) were included. At 1\u2009year, median monthly seizure frequency decreased by 82.5% (40\u20137;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). The incidence of status epilepticus declined by 92.8%, acute prolonged seizures by 80.9%, the burden of antiseizure medications by 25%, and epilepsy\u2010related hospitalizations by 100% (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Overall, 68.8% achieved \u226550% reduction and 11.8% became seizure\u2010free. On univariate analysis, comorbidities, multiple seizure types, higher baseline seizure frequency, greater number of antiseizure medications, and magnet use were inversely related to seizure freedom, while normal brain MRI showed a direct relationship. On multivariable analysis, only baseline seizure frequency \u226530\/month independently predicted seizure freedom (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.047), corresponding to 97.7% lower odds. A predictive model incorporating comorbidities and number of antiseizure medications improved discrimination (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) with 86.6% sensitivity and 81.8% specificity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Vagus nerve stimulation was associated with substantial seizure frequency reduction, lower morbidity, and less healthcare utilization, with a favorable safety profile. Baseline seizure burden emerged as the key predictor of seizure freedom and may guide patient selection, supporting earlier vagus nerve stimulation consideration in drug\u2010resistant epilepsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70202","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:59:07Z","timestamp":1771084747000},"page":"709-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vagus nerve stimulation for drug\u2010resistant epilepsy and predictors for seizure freedom: A nationwide multicenter cohort study in Mexico"],"prefix":"10.1002","volume":"28","author":[{"given":"Mar\u00eda F.","family":"Castelo\u2010Pablos","sequence":"first","affiliation":[{"name":"Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \u201cManuel Velasco Su\u00e1rez\u201d  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma M.","family":"Huerta\u2010Hurtado","sequence":"additional","affiliation":[{"name":"Unidad M\u00e9dica de Alta Especialidad, Hospital de Pediatr\u00eda Centro M\u00e9dico Nacional de Occidente, Instituto Mexicano del Seguro Social  Guadalajara Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Immer","family":"Armend\u00e1riz\u2010Betancourt","sequence":"additional","affiliation":[{"name":"Instituto de Neurociencias y Cl\u00ednica de Epilepsia  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Plascencia\u2010\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Epilepsia, Centro M\u00e9dico Nacional \u201c20 de Noviembre\u201d, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elma","family":"Paredes\u2010Arag\u00f3n","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \u201cManuel Velasco Su\u00e1rez\u201d  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia I.","family":"Mej\u00eda\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Neurolog\u00eda y Neurocirug\u00eda \u201cManuel Velasco Su\u00e1rez\u201d  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Infante\u2010Cant\u00fa","sequence":"additional","affiliation":[{"name":"Hospital Zambrano\u2010Hellion TecSalud  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horacio","family":"Sent\u00edes\u2010Madrid","sequence":"additional","affiliation":[{"name":"Laboratorio de Neurofisiolog\u00eda Cl\u00ednica, Departamento de Neurolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n \u201cSalvador Zubir\u00e1n\u201d  Mexico City 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