{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:29:26Z","timestamp":1788370166548,"version":"build-2803163510"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Vagus nerve stimulation (VNS) is an established adjunctive therapy for pediatric drug-resistant epilepsy (DRE), but objective evidence of its early impact on overall health is limited. Subjective seizure diaries can be influenced by placebo effects, whereas healthcare utilization may serve as a more objective window into the early post-operative course. This study aims to evaluate healthcare utilization in the immediate and subacute recovery phase (0\u20133\u00a0months) following VNS implantation in a large cohort of children with DRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective, single-center, single-surgeon study of 200 consecutive patients (&lt;\u200920\u00a0years old) with DRE who underwent first-time VNS implantation at a Level IV pediatric epilepsy center. The primary outcome was change in acute healthcare utilization, assessed by comparing rates of all-cause and seizure-related unplanned hospital admissions and emergency room (ER) visits in the 90\u00a0days before and after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Unplanned acute healthcare utilization significantly decreased in the 90-day post-operative window compared to preoperative baseline. All-cause unplanned hospital admissions decreased significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). This change was driven by a marked reduction in unplanned seizure-related admissions. Unplanned seizure-related admissions decreased from 34 events to 14 (58.8% reduction), and seizure-related ER visits fell from 60 to 35 (41.7% reduction). The acute surgical safety profile was excellent. Ambulatory concerns expressed by patients and caregivers (electronic, telephone, or in clinic encounters) were rare but most commonly involved pain, hoarseness, cough, and wound care questions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a large, consecutive, single-surgeon series, pediatric VNS implantation was associated with an early reduction in unplanned acute healthcare utilization and an exceptional surgical safety profile. Our observations suggest that VNS provides a rapid and clinically significant reduction in unplanned seizure-related hospital admissions and ER visits within the first 3 months of implantation. This suggests an early benefit of VNS for children with DRE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07245-5","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:13:20Z","timestamp":1778199200000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early reduction in unplanned healthcare utilization following vagus nerve stimulation for pediatric epilepsy"],"prefix":"10.1007","volume":"42","author":[{"given":"Rakesh A.","family":"Murugesan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel B.","family":"Tomlinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Melamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Galligan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin C.","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"7245_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13030780","author":"M Fukuda","year":"2024","unstructured":"Fukuda M, Matsuo T, Fujimoto S et al (2024) Vagus nerve stimulation therapy for drug-resistant epilepsy in children-a literature review. J Clin Med. https:\/\/doi.org\/10.3390\/jcm13030780","journal-title":"J Clin Med"},{"issue":"10","key":"7245_CR2","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1111\/epi.12762","volume":"55","author":"I Orosz","year":"2014","unstructured":"Orosz I, McCormick D, Zamponi N et al (2014) Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia 55(10):1576\u20131584. https:\/\/doi.org\/10.1111\/epi.12762","journal-title":"Epilepsia"},{"issue":"1","key":"7245_CR3","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.yebeh.2010.10.017","volume":"20","author":"RE Elliott","year":"2011","unstructured":"Elliott RE, Morsi A, Kalhorn SP et al (2011) Vagus nerve stimulation in 436 consecutive patients with treatment-resistant epilepsy: long-term outcomes and predictors of response. Epilepsy Behav 20(1):57\u201363. https:\/\/doi.org\/10.1016\/j.yebeh.2010.10.017","journal-title":"Epilepsy Behav"},{"issue":"22","key":"7245_CR4","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1212\/wnl.0000000000012030","volume":"96","author":"P Jain","year":"2021","unstructured":"Jain P, Arya R (2021) Vagus nerve stimulation and seizure outcomes in pediatric refractory epilepsy: systematic review and meta-analysis. Neurology 96(22):1041\u20131051. https:\/\/doi.org\/10.1212\/wnl.0000000000012030","journal-title":"Neurology"},{"key":"7245_CR5","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.yebeh.2018.09.014","volume":"88","author":"J Soleman","year":"2018","unstructured":"Soleman J, Stein M, Knorr C et al (2018) Improved quality of life and cognition after early vagal nerve stimulator implantation in children. Epilepsy Behav 88:139\u2013145. https:\/\/doi.org\/10.1016\/j.yebeh.2018.09.014","journal-title":"Epilepsy Behav"},{"issue":"2","key":"7245_CR6","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1016\/j.brs.2025.02.010","volume":"18","author":"K Mithani","year":"2025","unstructured":"Mithani K, Niazi F, Alhasan HA et al (2025) Long-term outcomes of vagus nerve stimulation in children with drug resistant epilepsy are driven by early benefit. Brain Stimul 18(2):246\u2013248. https:\/\/doi.org\/10.1016\/j.brs.2025.02.010","journal-title":"Brain Stimul"},{"issue":"1","key":"7245_CR7","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3171\/2016.1.Peds15534","volume":"18","author":"D R\u00e9v\u00e9sz","year":"2016","unstructured":"R\u00e9v\u00e9sz D, Rydenhag B, Ben-Menachem E (2016) Complications and safety of vagus nerve stimulation: 25 years of experience at a single center. J Neurosurg Pediatr 18(1):97\u2013104. https:\/\/doi.org\/10.3171\/2016.1.Peds15534","journal-title":"J Neurosurg Pediatr"},{"key":"7245_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.bas.2023.102733","volume":"4","author":"J van Schooten","year":"2024","unstructured":"van Schooten J, Smeets J, van Kuijk SMJ et al (2024) Surgical complications of vagus nerve stimulation surgery: a 14-years single-center experience. Brain Spine 4:102733. https:\/\/doi.org\/10.1016\/j.bas.2023.102733","journal-title":"Brain Spine"},{"key":"7245_CR9","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.seizure.2025.02.013","volume":"127","author":"E Begolli","year":"2025","unstructured":"Begolli E, Winther CH, Miranda MJ, Mol Debes N (2025) The placebo effect in the treatment of children with epilepsy: a systematic review. Seizure 127:7\u201315. https:\/\/doi.org\/10.1016\/j.seizure.2025.02.013","journal-title":"Seizure"},{"issue":"5","key":"7245_CR10","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1111\/epi.17208","volume":"63","author":"L Zhang","year":"2022","unstructured":"Zhang L, Hall M, Lam SK (2022) Hospital costs associated with vagus nerve stimulation and\u00a0medical treatment in pediatric patients with refractory\u00a0epilepsy. Epilepsia 63(5):1141\u20131151. https:\/\/doi.org\/10.1111\/epi.17208","journal-title":"Epilepsia"},{"issue":"3","key":"7245_CR11","doi-asserted-by":"publisher","first-page":"260","DOI":"10.3171\/2024.4.PEDS23310","volume":"34","author":"N Muthiah","year":"2024","unstructured":"Muthiah N, Reecher HM, Abel TJ (2024) Effect of vagus nerve stimulation on emergency department utilization in children with drug-resistant epilepsy: a retrospective cohort study. J Neurosurg Pediatr 34(3):260\u2013267. https:\/\/doi.org\/10.3171\/2024.4.PEDS23310","journal-title":"J Neurosurg Pediatr"},{"key":"7245_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2021.107972","author":"ER Hudson","year":"2021","unstructured":"Hudson ER, Lesko A, Lucas L, Baraban E, Fertig EJ (2021) Healthcare utilization and cost outcomes for a multicenter first seizure and new onset epilepsy clinic. Epilepsy Behav. https:\/\/doi.org\/10.1016\/j.yebeh.2021.107972","journal-title":"Epilepsy Behav"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07245-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-026-07245-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-026-07245-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:13:20Z","timestamp":1778199200000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-026-07245-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7245"],"URL":"https:\/\/doi.org\/10.1007\/s00381-026-07245-5","relation":{},"ISSN":["1433-0350"],"issn-type":[{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"assertion":[{"value":"12 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Surgical Complications and Admission Rates After Vagus Nerve Stimulation in Children\n                      , AANS 2025.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Previous presentations"}}],"article-number":"206"}}