迷走神經刺激治療兒童藥物難治性癲癇的中國專家共識_Journal of Epilepsy

Authors：

 中國醫師協會神經調控專業委員會 , 中國抗癲癇協會神經調控專業委員會

執筆吳曄（北京大學第一醫院），張凱（首都醫科大學附屬北京天壇醫院），劉慶祝（北京大學第一醫院），邵曉秋（首都醫科大學附屬北京天壇醫院），欒國明（首都醫科大學三博腦科醫院），張建國（首都醫科大學附屬北京天壇醫院）;

Corresponding?author：

中國醫師協會神經調控專業委員會, Email: zjguo73@126.com

Keywords：

DOI：

10.7507/2096-0247.202410013

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Citation： 中國醫師協會神經調控專業委員會, 中國抗癲癇協會神經調控專業委員會. 迷走神經刺激治療兒童藥物難治性癲癇的中國專家共識. Journal of Epilepsy, 2025, 11(1): 1-11. doi: 10.7507/2096-0247.202410013 Copy

1.	Schachter SC, Saper CB. Vagus nerve stimulation. Epilepsia, 1998, 39(7): 677-686.
2.	中國醫師協會神經內科分會癲(癎)專委會. 迷走神經刺激術治療癲(癎)的中國專家共識. 中國醫師雜志, 2015, 17(7): 967-968.
3.	中國抗癲癇協會神經調控專業委員會, 中國醫師協會神經調控專業委員會, 中華醫學會神經外科分會神經生理學組. 迷走神經刺激治療藥物難治性癲癇的中國專家共識. 癲癇雜志, 2021, 7(3): 191-196.
4.	McMillan SS, King M, Tully MP. How to use the nominal group and Delphi techniques. Int J Clin Pharm, 2016, 38(3): 655-662.
5.	Jain P, Arya R. Vagus nerve stimulation and seizure outcomes in pediatric refractory epilepsy: systematic review and meta-analysis. Neurology, 2021, 96(22): 1041-1051.
6.	Orosz I, McCormick D, Zamponi N, et al. Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia, 2014, 55(10): 1576-1584.
7.	Feygina AA, Koshelyaevskaya YN, Dibué M, et al. Efficacy and safety following two or more years of vagus nerve stimulation (VNS Therapy) in pediatric patients with drug-resistant epilepsy enrolled in a Russian VNS Registry. Brain & Behavior, 2023, 13(7): e3076.
8.	Muthiah N, Zhang J, Remick M, et al. Efficacy of vagus nerve stimulation for drug-resistant epilepsy in children age six and younger. Epilepsy & Behavior, 2020, 112: 107373.
9.	Englot DJ, Chang EF, Auguste KI. Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response: a review. JNS, 2011, 115(6): 1248-1255.
10.	Alexopoulos AV, Kotagal P, Loddenkemper T, et al. Long-term results with vagus nerve stimulation in children with pharmacoresistant epilepsy. Seizure, 2006, 15(7): 491-503.
11.	Benifla M, Rutka JT, Logan W, et al. Vagal nerve stimulation for refractory epilepsy in children: indications and experience at the hospital for sick children. Childs Nerv Syst, 2006, 22(8): 1018-1026.
12.	Murphy JV, Torkelson R, Dowler I, et al. Vagal nerve stimulation in refractory epilepsy: The first 100 patients receiving vagal nerve stimulation at a pediatric epilepsy center. Arch Pediatr Adolesc Med, 2003, 157(6): 560.
13.	Helmers SL, Wheless JW, Frost M, et al. Vagus nerve stimulation therapy in pediatric patients with refractory epilepsy: retrospective Study. J Child Neurol, 2001, 16(11): 843-848.
14.	Sauer V, Glaser M, Ellwardt E, et al. Favorable combinations of antiseizure medication with vagus nerve stimulation to improve health-related quality of life in patients with epilepsy. Epilepsy & Behavior, 2024, 150: 109562.
15.	Chrastina J, Novák Z, Zeman T, et al. Single-center long-term results of vagus nerve stimulation for epilepsy: a 10–17 year follow-up study. Seizure, 2018, 59: 41-47.
16.	Chrastina J, Kocvarova J, Novak Z, et al. Older age and longer epilepsy duration do not predict worse seizure reduction outcome after vagus nerve stimulation. J Neurol Surg A Cent Eur Neurosurg, 2018, 79(02): 152-158.
17.	Hilderink J, Tjepkema-Cloostermans MC, Geertsema A, et al. Predicting success of vagus nerve stimulation (VNS) from EEG symmetry. Seizure, 2017, 48: 69-73.
18.	Ching J, Khan S, White P, et al. Long-term effectiveness and tolerability of vagal nerve stimulation in adults with intractable epilepsy: a retrospective analysis of 100 patients. British Journal of Neurosurgery, 2013, 27(2): 228-234.
19.	Scherrmann J, Hoppe C, Kral T, et al. Vagus nerve stimulation: clinical experience in a large patient series. Journal of Clinical Neurophysiology, 2001, 18(5): 408-414.
20.	Amar AP, DeGiorgio CM, Tarver WB, et al. Long-term multicenter experience with vagus nerve stimulation for intractable partial seizures. Stereotact Funct Neurosurg, 1999, 73(1-4): 104-108.
21.	Wang HJ, Tan G, Zhu LN, et al. Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy. Seizure, 2019, 66: 53-60.
22.	Englot DJ, Rolston JD, Wright CW, et al. Rates and predictors of seizure freedom with vagus nerve stimulation for intractable epilepsy. Neurosurgery, 2016, 79(3): 345-353.
23.	Kostov KH, Kostov H, Larsson PG, et al. Norwegian population-based study of long-term effects, safety, and predictors of response of vagus nerve stimulation treatment in drug-resistant epilepsy: The NORPulse study. Epilepsia, 2022, 63(2): 414-425.
24.	Xie H, Ma J, Ji T, et al. Efficacy of vagus nerve stimulation in 95 children of drug-resistant epilepsy with structural etiology. Epilepsy & Behavior, 2023, 140: 109107.
25.	Workewych AM, Arski ON, Mithani K, et al. Biomarkers of seizure response to vagus nerve stimulation: a scoping review. Epilepsia, 2020, 61(10): 2069-2085.
26.	Zhang Y, Wang X, Tang C, et al. Genetic variations of adenosine kinase as predictable biomarkers of efficacy of vagus nerve stimulation in patients with pharmacoresistant epilepsy. Journal of Neurosurgery, 2022, 136(3): 726-735.
27.	Ma J, Wang Z, Cheng T, et al. A prediction model integrating synchronization biomarkers and clinical features to identify responders to vagus nerve stimulation among pediatric patients with drug-resistant epilepsy. CNS Neurosci Ther, 2022, 28(11): 1838-1848.
28.	Geng G, Hu W, Meng Y, et al. Vagus nerve stimulation for treating developmental and epileptic encephalopathy in young children. Front Neurol, 2023, 14: 1191831.
29.	Klinkenberg S, Van Den Bosch CNCJ, Majoie HJM, et al. Behavioural and cognitive effects during vagus nerve stimulation in children with intractable epilepsy – a randomized controlled trial. European Journal of Paediatric Neurology, 2013, 17(1): 82-90.
30.	Morris GL, Gloss D, Buchhalter J, et al. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2013, 81(16): 1453-1459.
31.	Ostendorf AP, Ng YT. Treatment-resistant Lennox-Gastaut syndrome: therapeutic trends, challenges and future directions. Neuropsychiatr Dis Treat, 2017, 13: 1131-1140.
32.	中國抗癲癇協會創新與轉化專委會. Lennox-Gastaut綜合征診斷治療的中國專家共識. 癲癇雜志, 2022, 8(3): 187-195.
33.	Dibué M, Greco T, Spoor JKH, et al. Vagus nerve stimulation in patients with Lennox-Gastaut syndrome: a meta-analysis. Acta Neurol Scand, 2021, 143(5): 497-508.
34.	Cersósimo RO, Bartuluchi M, Fortini S, et al. Vagus nerve stimulation: effectiveness and tolerability in 64 paediatric patients with refractory epilepsies. Epileptic Disorders, 2011, 13(4): 382-388.
35.	Abdelmoity SA, Abdelmoity AA, Riordan SM, et al. The efficacy and tolerability of auto-stimulation-VNS in children with Lennox-Gastaut syndrome. Seizure, 2021, 86: 168-174.
36.	Dravet C. Les epilepsies graves de l’enfant. VIE MED. 1978;59(8): 543-548.
37.	中國抗癲癇協會創新與轉化專業委員會 , 中華醫學會兒科學分會罕見病學組 , 中華醫學會兒科學分會神經學組. Dravet綜合征診斷與治療的中國專家共識. 癲癇雜志, 2024, 10(1): 1-11.
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1. Schachter SC, Saper CB. Vagus nerve stimulation. Epilepsia, 1998, 39(7): 677-686.
2. 中國醫師協會神經內科分會癲(癎)專委會. 迷走神經刺激術治療癲(癎)的中國專家共識. 中國醫師雜志, 2015, 17(7): 967-968.
3. 中國抗癲癇協會神經調控專業委員會, 中國醫師協會神經調控專業委員會, 中華醫學會神經外科分會神經生理學組. 迷走神經刺激治療藥物難治性癲癇的中國專家共識. 癲癇雜志, 2021, 7(3): 191-196.
4. McMillan SS, King M, Tully MP. How to use the nominal group and Delphi techniques. Int J Clin Pharm, 2016, 38(3): 655-662.
5. Jain P, Arya R. Vagus nerve stimulation and seizure outcomes in pediatric refractory epilepsy: systematic review and meta-analysis. Neurology, 2021, 96(22): 1041-1051.
6. Orosz I, McCormick D, Zamponi N, et al. Vagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children. Epilepsia, 2014, 55(10): 1576-1584.
7. Feygina AA, Koshelyaevskaya YN, Dibué M, et al. Efficacy and safety following two or more years of vagus nerve stimulation (VNS Therapy) in pediatric patients with drug-resistant epilepsy enrolled in a Russian VNS Registry. Brain & Behavior, 2023, 13(7): e3076.
8. Muthiah N, Zhang J, Remick M, et al. Efficacy of vagus nerve stimulation for drug-resistant epilepsy in children age six and younger. Epilepsy & Behavior, 2020, 112: 107373.
9. Englot DJ, Chang EF, Auguste KI. Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response: a review. JNS, 2011, 115(6): 1248-1255.
10. Alexopoulos AV, Kotagal P, Loddenkemper T, et al. Long-term results with vagus nerve stimulation in children with pharmacoresistant epilepsy. Seizure, 2006, 15(7): 491-503.
11. Benifla M, Rutka JT, Logan W, et al. Vagal nerve stimulation for refractory epilepsy in children: indications and experience at the hospital for sick children. Childs Nerv Syst, 2006, 22(8): 1018-1026.
12. Murphy JV, Torkelson R, Dowler I, et al. Vagal nerve stimulation in refractory epilepsy: The first 100 patients receiving vagal nerve stimulation at a pediatric epilepsy center. Arch Pediatr Adolesc Med, 2003, 157(6): 560.
13. Helmers SL, Wheless JW, Frost M, et al. Vagus nerve stimulation therapy in pediatric patients with refractory epilepsy: retrospective Study. J Child Neurol, 2001, 16(11): 843-848.
14. Sauer V, Glaser M, Ellwardt E, et al. Favorable combinations of antiseizure medication with vagus nerve stimulation to improve health-related quality of life in patients with epilepsy. Epilepsy & Behavior, 2024, 150: 109562.
15. Chrastina J, Novák Z, Zeman T, et al. Single-center long-term results of vagus nerve stimulation for epilepsy: a 10–17 year follow-up study. Seizure, 2018, 59: 41-47.
16. Chrastina J, Kocvarova J, Novak Z, et al. Older age and longer epilepsy duration do not predict worse seizure reduction outcome after vagus nerve stimulation. J Neurol Surg A Cent Eur Neurosurg, 2018, 79(02): 152-158.
17. Hilderink J, Tjepkema-Cloostermans MC, Geertsema A, et al. Predicting success of vagus nerve stimulation (VNS) from EEG symmetry. Seizure, 2017, 48: 69-73.
18. Ching J, Khan S, White P, et al. Long-term effectiveness and tolerability of vagal nerve stimulation in adults with intractable epilepsy: a retrospective analysis of 100 patients. British Journal of Neurosurgery, 2013, 27(2): 228-234.
19. Scherrmann J, Hoppe C, Kral T, et al. Vagus nerve stimulation: clinical experience in a large patient series. Journal of Clinical Neurophysiology, 2001, 18(5): 408-414.
20. Amar AP, DeGiorgio CM, Tarver WB, et al. Long-term multicenter experience with vagus nerve stimulation for intractable partial seizures. Stereotact Funct Neurosurg, 1999, 73(1-4): 104-108.
21. Wang HJ, Tan G, Zhu LN, et al. Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy. Seizure, 2019, 66: 53-60.
22. Englot DJ, Rolston JD, Wright CW, et al. Rates and predictors of seizure freedom with vagus nerve stimulation for intractable epilepsy. Neurosurgery, 2016, 79(3): 345-353.
23. Kostov KH, Kostov H, Larsson PG, et al. Norwegian population-based study of long-term effects, safety, and predictors of response of vagus nerve stimulation treatment in drug-resistant epilepsy: The NORPulse study. Epilepsia, 2022, 63(2): 414-425.
24. Xie H, Ma J, Ji T, et al. Efficacy of vagus nerve stimulation in 95 children of drug-resistant epilepsy with structural etiology. Epilepsy & Behavior, 2023, 140: 109107.
25. Workewych AM, Arski ON, Mithani K, et al. Biomarkers of seizure response to vagus nerve stimulation: a scoping review. Epilepsia, 2020, 61(10): 2069-2085.
26. Zhang Y, Wang X, Tang C, et al. Genetic variations of adenosine kinase as predictable biomarkers of efficacy of vagus nerve stimulation in patients with pharmacoresistant epilepsy. Journal of Neurosurgery, 2022, 136(3): 726-735.
27. Ma J, Wang Z, Cheng T, et al. A prediction model integrating synchronization biomarkers and clinical features to identify responders to vagus nerve stimulation among pediatric patients with drug-resistant epilepsy. CNS Neurosci Ther, 2022, 28(11): 1838-1848.
28. Geng G, Hu W, Meng Y, et al. Vagus nerve stimulation for treating developmental and epileptic encephalopathy in young children. Front Neurol, 2023, 14: 1191831.
29. Klinkenberg S, Van Den Bosch CNCJ, Majoie HJM, et al. Behavioural and cognitive effects during vagus nerve stimulation in children with intractable epilepsy – a randomized controlled trial. European Journal of Paediatric Neurology, 2013, 17(1): 82-90.
30. Morris GL, Gloss D, Buchhalter J, et al. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2013, 81(16): 1453-1459.
31. Ostendorf AP, Ng YT. Treatment-resistant Lennox-Gastaut syndrome: therapeutic trends, challenges and future directions. Neuropsychiatr Dis Treat, 2017, 13: 1131-1140.
32. 中國抗癲癇協會創新與轉化專委會. Lennox-Gastaut綜合征診斷治療的中國專家共識. 癲癇雜志, 2022, 8(3): 187-195.
33. Dibué M, Greco T, Spoor JKH, et al. Vagus nerve stimulation in patients with Lennox-Gastaut syndrome: a meta-analysis. Acta Neurol Scand, 2021, 143(5): 497-508.
34. Cersósimo RO, Bartuluchi M, Fortini S, et al. Vagus nerve stimulation: effectiveness and tolerability in 64 paediatric patients with refractory epilepsies. Epileptic Disorders, 2011, 13(4): 382-388.
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