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Vagus nerve stimulation (VNS) is a relatively new treatment for epilepsy. Neurosurgeons at Children's Hospital Boston participated in the clinical trials validating its use as a treatment for epilepsy in 1994 and have been implanting the device routinely since 1997. Over 500 operations have been done, making Children's hospital among the most active epilepsy centers for VNS therapy in the world.
The device delivers small pulses of electrical current to the vagus nerve -- one of the major nerves leading to the brain. Though it is not yet understood precisely how it works, most patients see a reduction in the number and severity of seizures after the device is implanted. The median reduction in seizure frequency is about 50%. It can help control seizures that have been resistant to other treatments. Part of the evaluation for VNS is to be sure that some other surgical or medical therapy might not be more effective.
The device consists of two parts: a pulse generator -- a smooth metal disk about the size of a half-dollar, and the electrodes -- thin, plastic-coated wires which run from the pulse generator under the skin, up the left side of the neck and are wrapped carefully around the vagus nerve. A surgeon implants the pulse generator under the patient's collarbone or into the armpit area, then threads the wires under the skin to a second incision over the vagus nerve. The surgery usually takes less than an hour, and is often done on an outpatient basis.
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Vagal Nerve Stimulator
