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Vagus Nerve Stimulation for Epilepsy Management

A stimulator is involved in the Vagus Nerve Stimulation therapy that is used for the treatment of epilepsy. The stimulator involves a pulse generator that is connected to the left vagus nerve in the neck. Mild and regular electrical stimulations are sent through the nerve which helps in calming down the irregularities in brain activity which lead to seizures.
Epilepsy can be treated in several ways, but the effectiveness of the treatment would heavily depend on the person. The vagus nerve stimulation therapy is not controlled with medication.

What is VNS Therapy?

A device would be implanted under the skin in the left chest. A wire connecting to the generator device is placed under the skin. The wire is wound around the vagus nerve in the neck. An outpatient clinic programs the device for regular delivery of the pulses. Not much is needed for this device to work. The person would not be normally aware of how and when the device works, i.e. the stimulation. If a person is feeling a seizure, a magnet needs to be swiped over the generator which had been placed on the chest. The brain would then be sent an extra burst of stimulation.

How does the therapy work?

The vagus nerve stimulation comes under the category of neuromodulation. Neuromodulation involves sending electrical stimulation to a few parts of the brain in order to change how the brain cells work. This vagus nerve is a part of the autonomic nervous system of the body. This part of the nervous system deals with the involuntary functions of the body like breathing or heartbeats. Information is sent from the brain to the other parts of the body and back to it.
Though it is not clearly known how the therapy actually works, it has been seen through researches that the seizures can be controlled by increasing the flow of blood to the key areas in the brain and raising the level of neurotransmitters in the brain, that can help control seizures.

What does the stimulator look like and how does it work?

The stimulator is much like a pacemaker, which is placed under the skin under the left collar bone. It is connected to the vagus nerve in the side of the neck. The stimulator in the chest would be connected by a lead to the vagus nerve in the left side of the neck. The electrodes are coiled around the neck and a small scar would be left where it was inserted.
The stimulator would normally be switched on within four weeks of implantation. The neurologist would program the length and strength of the stimulation. The amount of stimulation varies but it usually starts with a low and suitable level for the person. About 30 seconds of stimulation would be done every 5 minutes. The stimulator runs on a battery, which can last as much as 10 years.

How would the VNS therapy help during a seizure?

The special magnet offered to the patients can be run over the stimulator for a stronger burst. This would help the warning from growing into a seizure. The magnet is generally worn around the wrist.

Are there any side effects to the therapy?
The side effects sometimes occur during the stimulation of the nerve which includes a little discomfort on the throat, a hoarse voice, swallowing difficulties or a cough. The side effects do not need switching off of the stimulator. The settings can be adjusted if needed.

Who would be considered for the therapy?

The VNS therapy becomes an option if the Automation External Defibrillators have not worked full in controlling the seizures and you would not like to have brain surgery or not suitable for it. The neurologist would be able to offer better information regarding your particular case.

Technology has improved over the years, which means the devices have become much more sophisticated and treatment of epilepsy has definitely improved. The Vagus Nerve Stimulation is one of the best ways to manage epilepsy.

Authored by Dr. Shyam Sundar K

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Dr. Shyam Sundar K

Dr. Shyam Sundar K is an eminent name in the field of neurology. He is one of the best neurosurgeon in Chennai, Tamil Nadu

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