目的 探讨迷走神经刺激术(VNS)对癫痫性脑病患儿认知功能的影响。方法 回顾分析于2016年10月— 2018年8月完成VNS的癫痫性脑病患儿的临床资料;采用能力评价量表评估VNS治疗前与治疗后12个月的语言能力、运 动能力、注意力和认知能力。结果 纳入15例患儿,男7例、女8例,平均年龄(7.3±1 . 76)岁;其中Lennox-Gastaut综合 征8例,Dravet综合征4例,Doose综合征3例。患儿平均病程(5.46±2.19)年(1~9年)。与治疗前比较,患儿在VNS治疗 后12个月时的语言能力、注意力、认知能力得分均显著升高,差异有统计学意义(P50 %,5例发作减少率≤50 %;VNS治疗前与治疗后12个月,两组间语言能力、运动能力、注 意力、认知能力各项评分改变的差异无统计学意义(P>0 . 05)。结论 VNS可以改善癫痫性脑病患儿的语言能力、注意力 和认知能力,与VNS是否减少癫痫发作无相关性。
Objective To investigate the effect of vagus nerve stimulation (VNS) on cognitive function in children with epileptic encephalopathy. Method Fifteen children from October 2016 to August 2018 with epileptic encephalopathy were selected according to inclusion criteria and exclusion criteria. Clinical data of 15 children were collected and followed up for 1-2 years. VNS was followed up for the first time 2 weeks after startup, for the second time 3 months after startup, and once every 3 months thereafter for a total of 1 - 2 years. The follow-up included epileptic seizure and cognitive improvement after VNS treatment. The improvement of cognitive ability before and after treatment was compared and analyzed. Results A total of 15 patients were enrolled in this study, including 7 males and 8 females with an average age of ( 7 . 3 ± 1 . 76 ) years. There were 8 cases of Lennox-Gastaut syndrome, 4 cases of Dravet syndrome and 3 cases of Doose syndrome. The duration of epilepsy was 1 - 9 years, with an average of ( 5. 46 ± 2. 19 ) years. After 12 months’ follow-up, the patient's language ability, attention, cognitive ability after treatment were improved significantly (P < 0 . 05 ); in contrast, exercise capacity improvement is not obvious (P > 0 . 05 ). For 12 months after VNS therapy, seizures loss was >50% in ten cases and ≤ 50% in five cases. Language ability, athletic ability, attention, and improvement of their cognitive abilities, showed no difference in these two groups (P > 0.05). Conclusion VNS can improve the language ability, attention ability and cognitive ability of children with epileptic encephalopathy.