Improved seizure control and regaining cognitive milestones after vagus nerve stimulation revision surgery in Lennox–Gastaut syndrome

We report a child with Lennox–Gastaut syndrome with an increase in seizure frequency and loss of psychomotor skills due to a disintegrated cervical VNS lead, not detected during standard device monitoring. The lead was completely removed and replaced by a new 303 lead on the same nerve segment. After reinitiating VNS, side effects forced us to switch it off, resulting in immediate seizure recurrence. EEG recording demonstrated a non-convulsive status epilepticus that was halted by reinitiating VNS therapy. Thereafter, he remained seizure free for eight months, and regained psychomotor development. Keywords: Lennox–Gastaut syndrome, Refractory epilepsy, Revision surgery, Seizure freedom, Vagus nerve stimulatio