Royal College of Surgeons in Ireland

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Vagus nerve stimulation in refractory idiopathic generalised epilepsy: an Irish retrospective observational study

journal contribution
posted on 2023-10-09, 14:10 authored by Javier Peña-Ceballos, Patrick MoloneyPatrick Moloney, Antonio Valentin, Cara O'Donnell, Niamh Colleran, Brenda Liggan, Breege Staunton-Grufferty, Patricia Ennis, Roger Grogan, Gerard Mullins, Daniel J Costello, Colin P Doherty, Kieron SweeneyKieron Sweeney, Hany El-NaggarHany El-Naggar, Ronan KilbrideRonan Kilbride, Peter Widdess-Walsh, Donncha O'BrienDonncha O'Brien, Norman DelantyNorman Delanty

Objective: Refractory idiopathic generalised epilepsy (IGE; also known as genetic generalised epilepsy) is a clinical challenge due to limited available therapeutic options. While vagus nerve stimulation (VNS) is approved as an adjunctive treatment for drug-resistant focal epilepsy, there is limited evidence supporting its efficacy for refractory IGE.

Methods: We conducted a single-centre retrospective analysis of adult IGE patients treated with VNS between January 2003 and January 2022. We analysed the efficacy, safety, tolerability, stimulation parameters and potential clinical features of VNS response in this IGE cohort.

Results: Twenty-three IGE patients were implanted with VNS between January 2003 and January 2022. Twenty-two patients (95.65%) were female. The median baseline seizure frequency was 30 per month (interquartile range [IQR]= 140), including generalised tonic-clonic seizures (GTCS), absences, myoclonus, and eyelid myoclonia with/without absences. The median number of baseline anti-seizure medications (ASM) was three (IQR= 2). Patients had previously failed a median of six ASM (IQR= 5). At the end of the study period, VNS therapy remained active in 17 patients (73.9%). amongst patients who continued VNS, thirteen (56.5% of the overall cohort) were considered responders (≥50% seizure frequency reduction). Amongst the clinical variables analysed, only psychiatric comorbidity correlated with poorer seizure outcomes, but was non-significant after applying the Bonferroni correction. Although 16 patients reported side-effects, none resulted in the discontinuation of VNS therapy.

Significance: Over half of the patients with refractory IGE experienced a positive response to VNS therapy. VNS represents a viable treatment option for patients with refractory IGE, particularly for females, when other therapeutic options have been exhausted.



The original article is available at

Published Citation

Peña-Ceballos J. et al. Vagus nerve stimulation in refractory idiopathic generalised epilepsy: An Irish retrospective observational study. Seizure. 2023;112:98-105.

Publication Date

25 September 2023

PubMed ID



  • Beaumont Hospital
  • FutureNeuro Centre
  • School of Pharmacy and Biomolecular Sciences




  • Accepted Version (Postprint)