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Vagus Nerve Stimulation Therapy: An Intellectual Disabilities Perspective

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Epilepsy and Intellectual Disabilities

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Numerous studies have now been published confirming the high prevalence of epilepsy in people with intellectual disabilities (ID).1–3 McDermott and colleagues3 compared the rates of epilepsy between ID and non-ID groups living in the community. The non-LD group had an epilepsy prevalence rate of 1%. The prevalence of epilepsy within the LD group was 13% for cerebral palsy, 13.6% for Down syndrome (DS), 25.4% for autism, 25.5% for mental retardation, and 40% for adults with both cerebral palsy and ID. Further, the researchers found that during the decades of adulthood, the prevalence of epilepsy declined for those with cerebral palsy and ID. The prevalence of epilepsy increased with advancing years for adults with DS and autism. For each decade, the prevalence of epilepsy was higher in the ID group compared to the non-ID group.

A significant proportion of persons with ID will have intractable epilepsy. Antiepileptic drugs (AEDs) remain the principal form of management for intractable epilepsy with up to 40% of individuals on polytherapy. However, poor seizure control may still be evident, leading to the consideration of alternative treatments. The principal alternative form of treatment is psychosurgery, but this is not readily accessible to persons with ID. Vagus nerve stimulation (VNS) therapy has the potential to be the main practical and efficacious treatment alternative to AEDs for individuals with ID who suffer from intractable epilepsy. To date there is very limited information specifically focused on the role of VNS Therapy to treat epilepsy in the ID population. This review chapter examines the role of VNS Therapy in persons with ID.

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Authors and Affiliations

  1. Department of Neuropsychiatry, The Greenfields, Monyhull Hospital, Birmingham, UK

    V. P. Prasher MBChB, MMedSc, MRCPsych, MD, PhD, F.IASSID

  2. Department of Psychiatry, Queen Elizabeth Psychiatric Hospital, Birmingham, UK

    E. Furlong MBChB, MRCPsych

  3. Department of Psychiatry, Sandwell Mental Health and Social Care Trust, West Bromwich, UK

    L. Weerasena MBBS, MD, MRCPsych

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  1. V. P. Prasher MBChB, MMedSc, MRCPsych, MD, PhD, F.IASSID
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  2. E. Furlong MBChB, MRCPsych
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  3. L. Weerasena MBBS, MD, MRCPsych
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Editors and Affiliations

  1. Liverpool John Moore University and South Birmingham PCT, c/o Greenfields, Monyhull, Kings Norton, Birmingham, UK

    Vee P. Prasher MBChB, MRCPsych, MMedSc, MD, PhD, F.IASSID

  2. Welsh Centre for Learning Disabilities, Cardiff University, Cardiff, Wales UK

    Mike P. Kerr MBChB, MRCPsych, MSc, MPhil, F.IASSID

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Prasher, V.P., Furlong, E., Weerasena, L. (2008). Vagus Nerve Stimulation Therapy: An Intellectual Disabilities Perspective. In: Prasher, V.P., Kerr, M.P. (eds) Epilepsy and Intellectual Disabilities. Springer, London. https://doi.org/10.1007/978-1-84800-259-3_8

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