Neurol. pro Praxi, 2004; 2: 63-66

Stimulace nervus vagus v terapii farmakorezistentní epilepsie

prof. MUDr. Zdeněk Novák CSc1, doc. MUDr. Robert Kuba Ph.D2, prof. MUDr. Milan Brázdil Ph.D2, MUDr. Jan Chrastina Ph.D1, prof. MUDr. Ivan Rektor CSc2
1 Neurochirurgická klinika LF MU a FN Brno
2 I. neurologická klinika LF MU a FN u sv. Anny Brno

Keywords: epilepsie, nervus vagus, intermitentní stimulace.

Published: December 31, 2004  Show citation

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Novák Z, Kuba R, Brázdil M, Chrastina J, Rektor I. Stimulace nervus vagus v terapii farmakorezistentní epilepsie. Neurol. praxi. 2004;7(2):63-66.

Resekční výkon k eliminaci epileptogenního ložiska je možno dle literárních údajů provést u přibližně 30% nemocných. U zbývajících nemocných, kdy není možný resekční výkon, připadají do úvahy jiné zákroky - například callosotomie a vícečetné subpiální transsekce. V klinice byly ověřeny i stereotaktické operace - ať již destruktivní, nebo stimulační. Pro terapeutický efekt a bezpečnost získává na popularitě intermitentní elektrická stimulace levého nervu vagu. Práce se zabývá patofyziologickým podkladem metody, historií zavedení metody a pozitivními výsledky, které byly opakovaně publikovány v rámci klinických studií např. E 01-E 05. Popsán je implantovaný systém, kritéria výběru pacientů, některé aspekty operační techniky a v neposlední řadě i vzácné nežádoucí účinky a ojediněle zmiňované komplikace. Zdůrazněna je bezpečnost metodiky a velmi dobrý terapeutický efekt.

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