{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:51:45Z","timestamp":1777956705812,"version":"3.51.4"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"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). While\u2009~\u200950% of patients achieve clinically meaningful seizure reduction, non-responders may not undergo further evaluation for additional surgical options, leaving persistent risk for uncontrolled seizures and epilepsy-related morbidity and mortality. We evaluated rates of post-VNS surgical re-evaluation and epilepsy surgery among pediatric VNS non-responders and secondarily assessed seizure and antiseizure medication (ASM) outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective review of pediatric patients with DRE who underwent VNS implantation at our institution (2013\u20132020). Patients were classified as \u201cresponders\u201d if they achieved\u2009\u2265\u200950% seizure frequency reduction from baseline. Variables included demographics, operating surgeon, generator model, revision history, seizure type and frequency, and ASM burden. Groups were compared using chi-square and Student\u2019s\n                      <jats:italic>T<\/jats:italic>\n                      -tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-seven patients (25 responders, 22 non-responders) met inclusion criteria. Groups did not differ significantly in age, sex, race, operating surgeon, generator model, revision history, or baseline ASM burden. At follow-up, responders required fewer ASMs than non-responders (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Among non-responders, only 3\/22 patients (13.6%) underwent additional epilepsy surgery (two responsive neurostimulation, one corpus callosotomy), and all achieved meaningful seizure reduction postoperatively. Three deaths occurred in the non-responder group, none surgery-related.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nearly half of pediatric patients treated with VNS failed to achieve seizure reduction, yet few underwent re-evaluation for further surgical management despite favorable outcomes among those who did. Structured follow-up pathways are needed to ensure timely surgical re-assessment of pediatric VNS non-responders within comprehensive epilepsy programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07299-5","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:43:41Z","timestamp":1777952621000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical re-evaluation patterns among pediatric vagus nerve stimulation non-responders: a single-center retrospective study"],"prefix":"10.1007","volume":"42","author":[{"given":"James M.","family":"Mossner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunny","family":"Abdelmageed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Terrani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Votoupal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaudia","family":"Dziugan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heba","family":"Akbari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Pauley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bieber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandi K.","family":"Lam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Raskin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"7299_CR1","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1111\/j.1528-1167.2009.02397.x","volume":"51","author":"P Kwan","year":"2010","unstructured":"Kwan P, Arzimanoglou A, Berg AT et al (2010) Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. 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