Effct of fully vagal sheath peeling during vagus nerve stimulation on postoperative epileptic seizures

doi:10.3877/cma.j.issn.2095-9141.2023.03.006

Abstract

Abstract:

Objective

To analyze the clinical effect of fully stripping vagal sheath under microscope in the treatment of epilepsy patients by vagus nerve stimulation (VNS).

Methods

From October 2017 to May 2021, 160 patients with VNS who were admitted to Neurosurgery Department of Xijing Hospital of Air Force Military Medical University were selected. Among them, 80 patients were only routinely stripped of the vagus nerve sheath or not stripped of the sheath with the naked eye (operation group A), and 80 patients were fully stripped of the vagus nerve sheath under the microscope (operation group B). At 1, 3, 6, and 12 months of start-up after startup, the improvement of seizure, language cognitive function, and emotion in the two groups were observed under the optimal stimulus parameters.

Results

At 1, 3, 6, and 12 months after VNS surgery, the grade I improvement rate in the operation group B was significantly higher than that in the operation group A, and the overall effective rate was also higher than that in the operation group A, with statistical significance (P<0.05). After 12 months of VNS surgery, the language cognitive improvement rate and emotional improvement rate in the operation group B were higher than those in the operation group A, with statistical significance (P<0.05).

Conclusion

The precise surgical method of fully stripping the vagal sheath under microscope can significantly improve the seizure, language cognition and emotional changes of epilepsy patients after operation.

Key words: Epilepsy, Vagus nerve stimulation, Nerve sheath, Vagus nerve, Microtechnique

Li Wang, Lei Zhang, Xiaowei Fei, Xicai Yi, Yangang Wang. Effct of fully vagal sheath peeling during vagus nerve stimulation on postoperative epileptic seizures[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(03): 160-164.

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Figures/Tables 7

References 19

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组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	有效率
A手术组	80	17（21.3）	28（35.0）	10（12.5）	25（31.3）	55（68.8）
B手术组	80	37（46.3）	24（30.0）	5（6.3）	14（17.5）	66（82.5）
Z/χ²值			3.384			4.102
P值			0.001			0.043

组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	有效率
A手术组	80	17（21.3）	28（35.0）	10（12.5）	25（31.3）	55（68.8）
B手术组	80	37（46.3）	24（30.0）	5（6.3）	14（17.5）	66（82.5）
Z/χ²值			3.384			4.102
P值			0.001			0.043

组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	有效率
A手术组	80	18（22.5）	27（33.8）	11（13.8）	24（30.0）	56（70.0）
B手术组	80	33（41.3）	26（32.5）	8（10.0）	13（16.3）	67（83.8）
Z/χ²值			2.832			4.253
P值			0.005			0.040

组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	有效率
A手术组	80	18（22.5）	27（33.8）	11（13.8）	24（30.0）	56（70.0）
B手术组	80	33（41.3）	26（32.5）	8（10.0）	13（16.3）	67（83.8）
Z/χ²值			2.832			4.253
P值			0.005			0.040

组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	有效率
A手术组	80	18（22.5）	28（35.0）	16（20.0）	18（22.5）	62（77.5）
B手术组	80	36（45.0）	23（28.8）	9（11.2）	12（15.0）	68（85.0）
Z/χ²值			4.783			3.894
P值			0.003			0.041

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