Vagus nerve stimulation in refractory and super-refractory status epilepticus – a systematic review

  title={Vagus nerve stimulation in refractory and super-refractory status epilepticus – a systematic review},
  author={Maxine Dibu{\'e}-Adjei and Francesco Brigo and Takamichi Yamamoto and Kristl Vonck and Eugen Trinka},
  journal={Brain stimulation},

Refractory Status Epilepticus in Genetic Epilepsy—Is Vagus Nerve Stimulation an Option?

The results support the consideration of VNS implantation as a safe and effective adjunctive treatment for SRSE.

Neurostimulation in the treatment of refractory and super-refractory status epilepticus

Treatment of Super-Refractory Status Epilepticus: A Review

For patients with SRSE insufficient, evidence exists that any of the ASMs reviewed, inhalational anesthetics, ketogenic diet, acute VNS, brain surgery, and therapeutic hypothermia are effective treatments.

Vagus nerve stimulation for super-refractory status epilepticus in febrile infection–related epilepsy syndrome: a pediatric case report and literature review

A 29-month-old case is presented, diagnosed with FIRES, whose seizures were successfully controlled by utilization of VNS after ineffective response to intensive pharmacotherapy and ketogenic diet treatment.

Vagus nerve stimulation for focal seizures.

High frequency V NS was over one and a half times more effective than low frequency VNS, and a small number of favourable QOL effects were associated with VNS stimulation, but results were inconclusive between high- and low-level stimulation.

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

There is a lack of robust published data regarding the safety and effectiveness of various therapies, and there continues to be a need for large randomized multicenter trials comparing newer therapies to treat this refractory condition.

Update on the management of status epilepticus

There is a continuous, albeit relatively slow progress in knowledge regarding different aspect of status epilepticus; recent findings refine some treatment strategies and help improving patients’ outcomes.

The Effectiveness of Vagus Nerve Stimulation in Drug-Resistant Epilepsy Correlates with Vagus Nerve Stimulation-Induced Electroencephalography Desynchronization

This study is the first to statistically correlate interictal cortical desynchronization during ON periods with reduction in seizure frequency, and supports the hypothesis that the antiseizure effect of VNS is mediated by cortical des synchronization.

Long‐term outcomes after NORSE: Treatment with vagus nerve stimulation

VNS implantation was delayed to manage his epilepsy when the NORSE, ultimately due to autoimmune encephalitis, had resolved, and during long‐term follow‐up, no reduction in seizure frequency was achieved.



Vagus Nerve Stimulation (VNS) in Super Refractory New Onset Refractory Status Epilepticus (NORSE)

The successful use of VNS to acutely terminate status epileptus for seventy-two hours in this critically ill patient adds to current evidence that there is utility in using VNS for refractory status epilepticus.

The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol.

There is an urgent need for the establishment of a database of outcomes of individual therapies for super-refractory status epilepticus, which is an uncommon but important clinical problem with high mortality and morbidity rates.

Pharmacotherapy for Status Epilepticus

This comprehensive narrative review focuses on the pharmacotherapy of status epilepticus, presenting according to the four-staged approach outlined above, and providing pharmacological properties and efficacy/safety data for each antiepileptic drugaccording to the strength of scientific evidence from the available literature.

Super‐refractory status epilepticus: An approach to therapy in this difficult clinical situation

The range of possible therapies is outlined and an approach to therapy is discussed, which includes anesthesia, antiepileptic drug therapy, hypothermia and ICU therapy, other medical, immunological, and physical therapies.

Pharmacologic treatment of status epilepticus

Based on the favourable tolerability profile of levetiracetam and valproate, the authors prefer these drugs in established SE over phenytoin.