Since the mid-90s, the UCSD Epilepsy Center has participated in clinical trials for vagus nerve stimulation (VNS), a newer form of therapy that combats seizures with small pulses of electricity.
Patients with refractory seizures who are not surgery candidates may consider. Approved by the Food and Drug Administration in 1997, this medical device is implanted by a surgeon in the chest wall (like a pacemaker). A thin spiral stimulating lead is then tunneled under the skin, and wrapped loosely around the vagus nerve in the neck.
The surgery is done on an outpatient basis and most patients go home the same day. Later during office visits to the Epilepsy Center, the neurology team programs the stimulator (like programming a VCR) to optimize the result for each patient.
Typically, the device is programmed to stimulate for 10-30 seconds (ON), then cycle OFF for 2-5 minutes automatically. Some patients may also use a hand held magnet to produce an extra pulse of stimulation at the first sign of an aura or seizure warning. After this “boost”, the device goes back to the regular programmed cycle.
With this therapy, a small dose of electrical stimulation is used to combat the electrical abnormalities in the brain that lead to seizures. The generator is in the chest, the electrical pulse is applied to a nerve in the neck, but the anti-seizure effect takes place up in the brain.
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