Abstract Details

Older epilepsy patients are a fragile group who at times, are less tolerant to anti-seizure medications (ASM) and have a higher risk of comorbidities. One third of these patients may suffer from Medically Resistant Epilepsy and require further treatments. There is a lack of understanding regarding the impact of epilepsy on these patients’ lives, especially after VNS implantation, and how improvement of seizures could improve their QOL.

To analyze rates of quality of life(QOL) in relation to seizure frequency in medically resistant(MR) elderly patients who undergo VNS implantation.

A prospective study of patients implanted with VNS was initiated at Western University’s Epilepsy Program, to evaluate clinical outcomes and impact on quality of life. We selected MR patients ages 50 or older who were implanted with VNS, and who had completed QOLIE-10 questionnaires prior to implantation as well as 6 months after.

Seven MR elderly patients with VNS consented to participate in this study and the results were analyzed. The mean age of participants’ was 56.4(IQR= 62-52), 57.1%(n=4) were male. A mean of 7.5(n=7) ASM were tried prior to surgery(IQR=10-6). The most common type of seizures was generalized tonic clonic in 57.1%(n=4) and focal with impaired awareness in 57.1%(n=4). Patients experienced a mean frequency of 6.8 seizures per month (IQR=16-4). The mean QOLIE-10 score was 3.1(n=6)(IQR=3.54-2.63). Six months after VNS implantation, no major side effects were reported and mild side effects including coughing and choking sensation were reported by only 33.33%(n=3). Patients experienced a mean frequency of 3.33 seizures per month, 33%(n=3) were seizure-free, and the mean QOLIE-10 score was 3.27(n=4)(IQR=4.27-2.18).

VNS is a relatively effective at treating epilepsy in the elderly population with mild side effects. More prospective data regarding how the VNS can impact the QOL in the elderly population is needed.