Description:
Vagus nerve stimulation is used in children and adults with epilepsy, particularly complex partial epilepsy that remains incapacitating despite maximal anti-epileptic medication. The technique has also been used in children with medically refractory encephalopathic seizures, idiopathic seizures, primary generalised epilepsy and the Lennox-Gastaut syndrome, which is a young onset epileptic disorder characterised by multiple seizures types and developmental delay.
Epilepsy prevalence is 2% to 5% worldwide (World Health Organisation estimate). About 5% to 30% of people with epilepsy have medically refractory complex partial seizures.
A battery powered pulse generator device is implanted under the skin of the upper left chest. A wire is tunnelled under the skin and connected to the left vagus nerve in the neck (surgery time 45 minutes to 2 hours). Stimulation parameters (pulse width and frequency, current intensity, on/off cycles) are programmed into the pulse generator via a programming wand. Patients or carers may then switch the stimulator on and off by passing a magnet over the generator. The battery lasts 8-12 years and can be replaced under local anaesthetic. A typical treatment regimen might comprise intermittent stimulation for 30 seconds every 5 to 10 minutes throughout the day and night.
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