A 12-year-old boy was admitted to our department as part of our epilepsy surgery protocol. He was admitted for video EEG and for ultimate consideration for vagal nerve stimulator (VNS) insertion. He had a background of intractable epilepsy which had not responded to multiple antiepileptic medications.

Structured clinical question

In children with intractable or refractory or difficult epilepsy [population], does vagal nerve stimulation [intervention] reduce seizure frequency or rate [outcome]?

Search strategy and outcome

The search was performed independently by two people.

An advanced search of National Library for Health, AMED, BNI, EMBASE, HMIC, MEDLINE, PsycINFO, CINAHL and Health Business Elite was carried out.

Key words were: children, intractable epilepsy, vagal nerve stimulation, seizure frequency and seizure rate.

Fifteen papers were found, six were relevant to the question, and one was excluded due to small size. See table 1.

Commentary

As approximately one third of patients with epilepsy will …