Vagus Nerve Stimulation
If you are experiencing recurrent seizures that do not respond to medication, a device-based treatment called vagus nerve stimulation may be an option. A small pulse generator similar to a pacemaker is implanted under the skin of your chest and connected to a wire that is attached to your vagus nerve. The device delivers mild electrical signals along the nerve, which then sends signals to other areas of the brain to interrupt the seizure.
Vagus nerve stimulation is also a treatment for depression and is being studied for treatment of multiple sclerosis, migraines, and Alzheimer’s disease.
Your M Health Fairview MINCEP® Epilepsy Care team includes epileptologists, specially trained neurologists who focus on epilepsy and other seizure disorders, plus psychologists, physician assistants, nurse practitioners, nurse clinicians, pharmacists, neurologists, and neurosurgeons who are recognized nationally for their clinical research and innovative care. The MINCEP Epilepsy Care program has been designated a Level 4 Comprehensive Epilepsy Care Center in recognition of providing the highest level of complex evaluation, monitoring and treatment.
Implantation of a vagal nerve stimulator requires surgery, usually same-day surgery. A small incision is made in your chest near your collarbone to implant the pulse generator. The lead wire is connected to it and guided under the skin up to your neck, where it is attached to the left vagus nerve through another small incision.
A few weeks after surgery, your care provider will turn on the device and adjust the timing and the strength of the pulses to target your specific needs. This is done externally using a programmer and wand that communicate with the implanted device. Most likely, your care provider will program the device to automatically generate impulses at regular intervals. Most people cannot feel these impulses.
You will need to visit your doctor periodically to make sure your device is working properly. You will also be given a magnet that you can use to turn VNS therapy on and off by simply holding it over the implanted pulse generator in your chest. You may wish to turn off therapy while doing activities that may be affected by the therapy, such as singing or speaking in public. If you experience an aura prior to a seizure, you can use the magnet to deliver non-scheduled impulses to shorten the seizure or stop it altogether.
The goal of VNS therapy is to reduce the number, length, and severity of seizures, not to make seizures go away completely. It is designed to be used along with anti-seizure medications and other treatments, not to replace them. You may not note improvement until three months or longer after the device is implanted. Improvement may continue in subsequent months but complete cessation of seizures is rare.
Conditions We Treat
Vagal nerve stimulation is an advanced treatment usually limited to persons whose seizures can't be controlled by medication or who cannot safely undergo brain surgery for treatment of seizures. VNS therapy is also being investigated as a treatment for severe, recurrent depression, and other conditions.