VNS Therapy - Is It Right For My Child?
VNS (Vagus Nerve Stimulation) Therapy, a neuro-stimulation treatment option, is sometimes described as a pacemaker for the brain. VNS Therapy may be added to medications to help improve seizure control. The vagus nerve is one of the primary communication pathways between the body and the brain.1
VNS Therapy consists of a pacemaker-like device the size of a small watch and weighing less than one ounce. The device, or generator, is usually implanted in the left chest area during an outpatient procedure that does not involve brain surgery. A thin thread-like wire, or lead, connected to the generator, runs under the skin and is attached to the left vagus nerve in the neck. The device delivers mild, intermittently-pulsed signals to the vagus nerve, which then activates various areas of the brain. Using an external dose adjustment system, physicians adjust the stimulation duration, frequency and intensity. Treatment is automatically delivered at regular intervals all day, every day so treatment is automatic and continuous.1
Patients and their caregivers can use an external magnet that can be briefly held over the implant site to produce an extra dose of stimulation. This extra dose can potentially shorten or stop a seizure or decrease its intensity or the recovery period. The most common side effects associated with VNS Therapy include hoarseness or change in voice tone, sore throat, a feeling of shortness of breath and coughing. Side effects generally occur only while the generator is on and typically diminish over time.1
VNS therapy is an effective alternative to epileptic surgery for a wide range of seizure disorders, including partial onset, complex partial, generalized, and atonic seizures. Early research done on VNS Therapy and it’s effects on patients suffering from Lennox-Gastaut Syndrome saw significant improvement in alertness, mood, and social interaction. This led to further exploration into it’s use for treatment of generalized epilepsies.2
It is a treatment option for intractable epilepsy (seizure activity that has been treated with at least two anti-seizure medications at adequate dosage, with no improvement of seizure activity). The implantation is minimally invasive, and the device relatively simple to use. If you have a VNS—and it is not adequately controlling seizures, brain surgery is still an option—but VNS therapy can often be a good intermediate approach. On average 12% of patients achieve seizure freedom and are able to stop medication regimens as well. In addition over a 5 year follow up in a post-approval study, 64% of patients reported a greater than 50% reduction in the number of seizures.3 Because the side effects are mild in VNS therapy, there is no concern in having to adjust the patients day to day activities.2
2. Dr. Carl Barr, DO