Interpersonal communication skills related to seizure outcomes in pediatric patients with vagus nerve stimulation

Objective: Various clinical parameters have been reported to be associated with favorable seizure outcomes after vagus nerve stimulation (VNS); however, none of these parameters have been conclusively validated. Here, we evaluated interpersonal communication skills (IPCS) and seizure outcomes in pediatric patients treated with VNS. Methods: We enrolled 31 Japanese pediatric patients (mean +/- SD: 9.0 +/- 3.4 years old, range: 3-15 years old) who were treated with VNS and had at least 2 years of follow-up. We divided the patients into two groups: a responder group with >= 50% seizure reduction from the average number of seizures 2 months before VNS; and a nonresponder group with <50% seizure reduction. We assessed the clinical parameters for predicting responders after VNS, including the etiology of epilepsy, seizure characteristics, EEG and MRI findings, medications, the intelligence quotient and/or developmental quotient, and interpersonal communication skills (IPCS) between the two groups. We classified IPCS as the ability of patients to use at least simple-word communication in Japanese. Results: We found significantly favorable seizure outcomes (>50% seizure reduction) in 12 of 19 (63.2%) patients with IPCS after 2-year VNS compared with one of 12 (8.3%) patients without ICPS (p = 0.0031, Fisher exact test). IPCS showed an odds ratio of 14.6 (95% CI, 1.9-318) and a significant correlation with a favorable seizure outcome (p = 0.0077) in binominal logistic regression analysis. Conclusion: Feasible evaluation of IPCS by clinicians might predict the seizure outcome more than 2 years after VNS implantation in a pediatric population.