Vagus Nerve Stimulation Reduced Rescue Medication Use and Decreased Family Burden

Dr. Wheless (00:00):

Hi. I'm Dr. Jim Wheless. I'm Professor and Chief of Pediatric Neurology at the University of Tennessee Health Science Center, the Le Bonheur Chair of Neurology, and I direct the Le Bonheur Comprehensive Epilepsy Program at Neuroscience Institute at Le Bonheur Children's Hospital in Memphis, Tennessee.

(00:16):

The CORE-VNS trial was a modern study to look at the use of vagus nerve stimulation therapy in our patients with some of the most severe epilepsies. They are not responding to current medical treatment, and in spite of being on multiple medications, still having bad seizures and seizures that they often end up in the emergency department, or if the family is able to use immediate treatment medication, what we often call “rescue medication” at home, they can do that to prevent emergency department visits. We tracked that use in this study, and what we saw is as people had vagus nurse stimulation therapy added to their medication regimen, they decreased their use of that rescue medication. Coupled with that, interestingly enough, they had dramatic decreased uses in emergency room visitations and hospital stays.

(01:05):

I think for a neurologist, we have to think of two patients that we have here. We have the patient in front of us that's having really bad epilepsy, but we have their family they're surrounded by. If I'm having seizures where I go into convulsive activity, I could fall down and hurt myself, knock out a tooth, break a bone. My family members, whatever age I am, are then having to deal with that. If I'm having back-to-back bad seizures where they're bringing me to the hospital, they're missing work to do that. If I'm school age, they're leaving work to get me to school or they're meeting me at the hospital.

(01:39):

If they're giving me rescue to prevent that at home, if they're not having to do that as much, it really is not only my quality of life better as the patient ... I'm not having those really nasty, severe seizures ... but the family that's taking care of me can actually get on with their regular activities as well. They're not panicked that they've got to give me rescue meds or I'll end up in the emergency department, and they can take a deep breath and be under less stress as well. This really not only is dramatically better for the patient, but the whole family around them actually has a better quality of life as well.

(02:10):

I think what this tells us, beyond just counting seizures, I mean, numbers are one thing. We get it that regulatory bodies like those, but if let's say I have two seizures a week and all I do is sit here, stare off, play with my clothes, maybe smack my lips, have some chewy movements that last 30 seconds and I'm back in a minute, I don't fall off the stool, that's one thing. If every time I have that same seizure, I end up on the floor convulsing, and then having back-to-back seizures that require rescue, if I'm not having that worse seizure type, that more severe seizure, even if that now is converted, if you will, to where I just have that seizure where I stare off, that's a lot easier for my family, for me to live with, for them to deal with. All seizures are not the same. If I can impact these serious seizures, it's a huge benefit to that patient and family.