{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:55Z","timestamp":1776096475726,"version":"3.50.1"},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Vagus nerve stimulation (VNS) is an established adjunctive therapy for drug-resistant epilepsy (DRE). However, evidence regarding its efficacy in children with structural and nonstructural etiologies of epilepsy remains limited. Herein, the authors aimed to explore the effectiveness of VNS in patients with either etiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this retrospective single-center study, authors evaluated children (ages 2\u201318 years) with DRE due to nonlesional monogenic epilepsies (MEs) or malformations of cortical development (MCDs) who had undergone VNS device implantation between 2008 and 2024 and had \u2265 6 months of follow-up. Patients with tuberous sclerosis complex were excluded. Clinical, genetic, neuroimaging, VNS programming, and outcome data were extracted from medical records. The primary outcome was the responder rate, defined as &gt; 50% seizure reduction from baseline at 6 months, 12 months, and the last follow-up, in the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 336 VNS device recipients, 64 children with ME (n = 44) or MCD (n = 20) met the study inclusion criteria. The median follow-up was 3.5\u20134.0 years. The responder rate in the ME versus MCD group at 6 months, 1 year, and the last follow-up was 38.6% versus 42.1% (p = 0.77), 45.7% versus 44.4% (p = 0.46), and 47.6% versus 63.2% (p = 0.64), respectively. The\n                      <jats:italic>SCN1A<\/jats:italic>\n                      -related Dravet syndrome (\n                      <jats:italic>SCN1A<\/jats:italic>\n                      -DS) subgroup (n = 12) had a responder rate (50.0%) comparable to that of the non\u2013\n                      <jats:italic>SCN1A<\/jats:italic>\n                      -DS ME group (43.7%) at the last follow-up. The frequency of status epilepticus decreased significantly in both groups (p = 0.03). VNS was well tolerated, with mild to moderate side effects reported in &lt; 5% patients. No clinical variable, including age at seizure onset, epilepsy duration, or age at VNS device implantation predicted seizure outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>VNS therapy was noted to have a similar responder rate in children with DRE due to MEs or MCDs. Both groups experienced meaningful benefits, with a small proportion of patients experiencing mild side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.9.peds25340","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:06Z","timestamp":1769083206000},"page":"227-236","source":"Crossref","is-referenced-by-count":0,"title":["Seizure outcomes after VNS therapy in children with drug-resistant epilepsy due to monogenic etiologies versus malformations of cortical development"],"prefix":"10.3171","volume":"37","author":[{"given":"Sonali","family":"Singh","sequence":"first","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Waheed","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Aschner","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyndsey","family":"McRae","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivanna","family":"Yau","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlin","family":"Flynn","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suvasini","family":"Sharma","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Whitney","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, McMaster University, Hamilton, Ontario;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth J.","family":"Donner","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Costain","sequence":"additional","affiliation":[{"name":"Division of Clinical and Metabolic Genetics, Department of Paediatrics, Hospital for Sick Children, University of Toronto;"},{"name":"Genetics and Genome Biology Program, SickKids Research Institute, Toronto;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Go","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"},{"name":"Division of Neurology, Department of Pediatrics, British Columbia Children\u2019s Hospital, Vancouver, British Columbia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisha A.","family":"Christian","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital for Sick Children, Toronto; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George M.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital for Sick Children, Toronto; and"},{"name":"Neuroscience and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James T.","family":"Rutka","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital for Sick Children, Toronto; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puneet","family":"Jain","sequence":"additional","affiliation":[{"name":"Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Neurology","first-page":"296","article-title":"Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies","volume":"88","author":"Fiest KM","year":"2017","unstructured":"Fiest KM, Sauro KM, Wiebe S,  Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies. 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