Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

Objective The objective of this selective EBM review is to determine whether or not transcutaneous vagal nerve stimulation is an effective measure in reducing seizure frequency in adult patients with pharmacoresistant epilepsy.

Study Design This systematic review comprises a randomized controlled trial and an observational pilot study, both published in 2014, as well as a double-blind randomized control trial published in 2016.

Data Sources All articles were published and displayed in English. The articles were obtained via the PubMed database.

Outcomes Measured Reductions in average seizure frequency were analyzed based on data from patient seizure diaries. Secondary outcomes, including quality of life and seizure severity, were measured through the Quality of Life in Epilepsy-31 (QoLIE-31) and Liverpool Seizure Severity Scale (LSSS), respectively.

Results Aihua et al. and Peijing et al. demonstrated a significant reduction in seizure frequency, as well as significant improvements in QoLIE-31 and LSSS scores. Bauer et al. did not achieve statistically significant reductions in seizure frequency compared to the control, nor did they demonstrate significant improvements in the QoLIE-31 or LSSS scores.

Conclusion The results evaluated in this systematic review showed promise for the use of tVNS in the treatment of pharmacoresistent epilepsy. However, due to conflicting data and study design limitations, no definitive conclusion could be achieved at this time. Further study is required to better characterize the efficacy of tVNS in reducing seizure burden

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