Development of localized interictal epileptiform discharges following vagus nerve stimulation for lennox-gastaut syndrome: a case report

Acta Epileptologica

Case Report

Yaoduan Xu¹  Na Li²  Zongling Shen²  Xin Geng³  Renli Qi³  Wei Wang³  Jinghui Li³  Hualin Yu⁴ 

[1] Department of Neurosurgery, The Third People’s Hospital of Honghe Prefecture, 661000, Gejiu, China;Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China;Second Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China;Second Department of Neurosurgery, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, China;Yunnan Provincial Clinical Research Center for Neurological Disease, 650032, Kunming, China;

关键词: Vagus nerve stimulation;    Lennox-gastaut syndrome;    Epileptiform discharges;   

DOI  :  10.1186/s42494-022-00106-z

 received in 2022-03-26, accepted in 2022-07-07,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLennox-gastaut syndrome (LGS) is an epileptic encephalopathy often associated with behavioral and psychiatric disorders. Vagus nerve stimulation (VNS) has been approved effective for LGS treatment. Surgical resection is also an option for LGS patients with focal pathology, offering a high probability of seizure control. However, it is challenging to accurately localize the seizure focus.Case presentationThe case presented here is a 19-year-old male with a 16-year history of epilepsywith comorbid severe cognitive and psychiatric disorders. He was diagnosed with LGS due to generalized slow spike-wave discharges and multiple seizure types. He was treated with VNS in 2017 at the age of 15. After that, the frequency of the short tonic seizures decreased from 4–5 times per day to 2–5 times per year, and the generalized tonic–clonic seizure pattern did not recur, which had a frequency of 2–4 times per month before the surgery. In 2019, the generalized abnormal interictal epileptiform discharges changed to be localized in the right frontal–temporal lobe at the age of 17 years (2019).ConclusionsThis case report suggested that the generalized epileptiform discharges evolve into localized discharges after VNS treatment, which may help reveal the primary seizure focus for resection surgery in patients with LGS.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 1