{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T21:15:51Z","timestamp":1791148551281,"version":"4.1.0"},"reference-count":93,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:p>Vagus nerve stimulation (VNS) was approved by the US FDA in 1997 as an adjunctive treatment for medically refractory epilepsy. It is considered for use in patients who are poor candidates for resection or those in whom resection has failed. However, disagreement regarding the utility of VNS in epilepsy continues because of the variability in benefit reported across clinical studies. Moreover, although VNS was approved only for adults and adolescents with partial epilepsy, its efficacy in children and in patients with generalized epilepsy remains unclear. The authors performed the first meta-analysis of VNS efficacy in epilepsy, identifying 74 clinical studies with 3321 patients suffering from intractable epilepsy. These studies included 3 blinded, randomized controlled trials (Class I evidence); 2 nonblinded, randomized controlled trials (Class II evidence); 10 prospective studies (Class III evidence); and numerous retrospective studies. After VNS, seizure frequency was reduced by an average of 45%, with a 36% reduction in seizures at 3\u201312 months after surgery and a 51% reduction after &gt; 1 year of therapy. At the last follow-up, seizures were reduced by 50% or more in approximately 50% of the patients, and VNS predicted a \u2265 50% reduction in seizures with a main effects OR of 1.83 (95% CI 1.80\u20131.86). Patients with generalized epilepsy and children benefited significantly from VNS despite their exclusion from initial approval of the device. Furthermore, posttraumatic epilepsy and tuberous sclerosis were positive predictors of a favorable outcome. In conclusion, VNS is an effective and relatively safe adjunctive therapy in patients with medically refractory epilepsy not amenable to resection. However, it is important to recognize that complete seizure freedom is rarely achieved using VNS and that a quarter of patients do not receive any benefit from therapy.<\/jats:p>","DOI":"10.3171\/2011.7.jns11977","type":"journal-article","created":{"date-parts":[[2011,8,12]],"date-time":"2011-08-12T08:58:18Z","timestamp":1313139498000},"page":"1248-1255","source":"Crossref","is-referenced-by-count":471,"title":["Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response"],"prefix":"10.3171","volume":"115","author":[{"given":"Dario J.","family":"Englot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurtis I.","family":"Auguste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11977","series-title":"Epilepsy Behav","first-page":"475","article-title":"Long-term effects of 24-month treatment with vagus nerve stimulation on behaviour in children with Lennox-Gastaut syndrome","volume":"3","author":"Aldenkamp","year":"2002"},{"key":"b2-jns11977","series-title":"Seizure","first-page":"491","article-title":"Long-term results with vagus nerve stimulation in children with pharmacoresistant epilepsy","volume":"15","author":"Alexopoulos","year":"2006"},{"key":"b3-jns11977","series-title":"Epilepsia","first-page":"954","article-title":"Vagus nerve stimulation for the treatment of bilateral independent temporal lobe epilepsy","volume":"42","author":"Alsaadi","year":"2001"},{"key":"b4-jns11977","series-title":"Stereotact Funct Neurosurg","first-page":"104","article-title":"Long-term multicenter experience with vagus nerve stimulation for intractable partial seizures: results of the XE5 trial","volume":"73","author":"Amar","year":"1999"},{"key":"b5-jns11977","series-title":"Neurosurgery","first-page":"1265","article-title":"An institutional experience with cervical vagus nerve trunk stimulation for medically refractory epilepsy: rationale, technique, and outcome","volume":"43","author":"Amar","year":"1998"},{"key":"b6-jns11977","series-title":"Seizure","first-page":"579","article-title":"Vagus nerve stimulation for medically refractory epilepsy: a long-term follow-up study","volume":"16","author":"Ardesch","year":"2007"},{"key":"b7-jns11977","series-title":"Eur J Paediatr Neurol","first-page":"334","article-title":"The efficacy of vagal nerve stimulation in children with pharmacoresistant epilepsy: practical experience at a Turkish tertiary referral center","volume":"14","author":"Arhan","year":"2010"},{"key":"b8-jns11977","series-title":"Lancet Neurol","first-page":"477","article-title":"Vagus-nerve stimulation for the treatment of epilepsy","volume":"1","author":"Ben-Menachem","year":"2002"},{"key":"b9-jns11977","series-title":"Neurology","first-page":"1265","article-title":"Evaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years","volume":"52","author":"Ben-Menachem","year":"1999"},{"key":"b10-jns11977","series-title":"Epilepsia","first-page":"616","article-title":"Vagus nerve stimulation for treatment of partial seizures: 1. 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