Vagal nerve stimulator (VNS) therapy is used to control seizures by sending electrical impulses to the brain from the vagus nerve in the neck. This treatment controls the type of brain activity that often leads to seizures.
The vagus nerve is a cranial nerve that controls parasympathetic functions, sending signals to every organ in the body. The vagus nerve also collects information from all parts of the body. Overstimulation of the vagus nerve is the most common cause of fainting.
VNS therapy is used in children with epilepsy or seizures that are difficult to treat or do not respond to oral anticonvulsant medicines.
VNS therapy is used with medicines and is not a replacement for them. VNS therapy does not require brain surgery. A simple two- to four-hour procedure is required to implant a pacemaker-like device in the chest that is connected to the vagus nerve with a flexible wire called a lead.
Once implanted, the vagal nerve stimulator generates an electronic pulse to the vagus nerve at regular intervals every few minutes. The nerve transmits this signal to the brain. Older children who feel a seizure coming can trigger the electrical signal, which can often stop the seizure.
VNS therapy, in combination with medicines, reduces the number of seizures and their intensity. The treatment also shortens seizure recovery time.
More than 75,000 people use VNS therapy to treat epilepsy and seizures. The U.S. Food and Drug Administration approved the treatment in 1997. Focal seizures (which affect only one part or one side of the brain) respond well to vagal nerve stimulation, and a growing body of scientific literature shows that generalized seizures (which affect the whole brain or a large part of it and can affect consciousness) also respond to VNS therapy.
What to Expect
What to Expect
If your child shows signs of epilepsy or seizures that do not respond to other treatments, his or her neurologist may recommend a vagal nerve stimulator. You and your child will meet with a neurosurgeon before the procedure to discuss the procedure and answer your questions.
You can expect the following on the day of your child’s stimulator implantation procedure:
- Your child will be admitted to the hospital on the day of his or her surgery.
- General anesthesia is used during the procedure. This means your child will be asleep and will feel no pain.
- The neurosurgeon will make two small incisions:
- One under the skin of the chest to implant the generator
- One along the side of the neck to connect the lead to the vagus nerve
- After the procedure, your child will be moved to a recovery room.
- You can be with your child as he or she wakes up.
- A nurse will monitor your child’s heart rate, pulse and blood pressure.
- Once your child is fully awake, he or she may be moved to a patient room. Children stay in the hospital overnight for observation, antibiotics and pain control.
You can expect the following two weeks after the procedure:
- Your child will see his or her primary neurologist to program the generator device to the level of stimulation needed to begin treatment.
- Your child will visit the doctor every two weeks to increase the VNS stimulation settings.
- Once initial settings are reached, visits may occur monthly or once every three months.
- At each visit, the neurologist works with you and your child to achieve the right combination of medicines and VNS stimulation settings.
- Settings are changed with a magnetic wand used outside the body.
- The lead and generator battery are checked at every visit.
- The battery life is between seven and 10 years.
- When the battery power begins to run low, your child’s neurologist will schedule an appointment with the neurosurgeon.
- A second surgical procedure is required to replace the device’s generator, which can last up to nine years. This takes about an hour and does not require an overnight stay.
The risk of a vagal nerve stimulator procedure includes a small chance of infection at the incision site.
Key Points to Remember
Key Points to Remember
- Vagal nerve stimulator (VNS) therapy is used to control seizures by sending electrical impulses to the brain from the vagus nerve in the neck.
- This treatment is used in children with epilepsy or seizures that are difficult to treat or do not respond to oral anticonvulsant medicines.
- VNS therapy is used with medicines and is not a replacement for them.
- A simple one- to two-hour procedure is required to implant a pacemaker-like device in the chest that is connected to the vagus nerve with a flexible wire called a lead.
- After the procedure, your child will see his or her primary neurologist to program the generator device to the level of stimulation needed to begin treatment.
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