Skoči na glavni sadržaj

Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti, Vol. 556 No. 62-63, 2023.

Studija slučaja

https://doi.org/10.21857/y54jofvwem

Seizure freedom with vagus nerve stimulation in neurofibromatosis type 1: A case report

Asja Hodzic
Andreja Bujan Kovač
Andrej Desnica
Biljana Đapić Ivančić
David Ozretić
Goran Mrak
Niko Njirić
Jakob Nemir
Sibila Nanković
Vlatko Šulentić
Željka Petelin Gadže

Puni tekst: engleski pdf 391 Kb

str. 86-90

preuzimanja: 131

citiraj

Sažetak

Epileptic seizures in neurofibromatosis type 1 (NF1) have been a subject of investigation of numerous studies, however, their etiology has not yet been elucidated. They are usually well controlled with an- tiseizure medications (ASMs), but in some pharmacoresistant patients, vagus nerve stimulation (VNS) might present a complementary treatment modality. We present a 24-year-old male patient with NF1 who had temporal lobe seizures - focal autonomic seizures with impaired awareness and oroalimentary automatisms, as well as focal motor seizures with retained awareness, in addition to moderate intel- lectual disability. The most significant magnetic resonance (MRI) abnormalities included infiltrative changes of medulla oblongata, pons and cerebellum, as well as signal intensity changes with mild com- pression in the apex of the temporal lobes, insular cortex, putamen and medial part of the frontal lobe, all more prominent on the right, along with right mesial temporal sclerosis. Interictal electroencepha- logram (EEG) showed two independent epileptic foci – one in the right frontocentrotemporal region and the other in the left centrotemporal region. Throughout the years, he had been treated with several ASMs in monotherapy or polytherapy without success in seizure control. After an extensive preoperative evaluation, VNS implantation was performed and the patient has been seizure free for almost two years. Al- though a palliative intervention, VNS could be a powerful tool in the treatment of these patients and even lead to seizure freedom. To the best of our knowledge, this is the first case report where seizure freedom was achieved in a patient with NF1 following VNS implantation.

Ključne riječi

Neurofibromatosis; Pharmacoresistant epilepsy; Vagus nerve stimulation; Seizure freedom

Hrčak ID:

308343

URI

https://hrcak.srce.hr/308343

Datum izdavanja:

25.6.2023.

Posjeta: 414 *