![]() The epileptologist and the epilepsy nurse specialist discuss realistic expectations of VNS therapy, how VNS works, the surgical procedure, post-operative care, advantages and disadvantages, continuing medication, the admission process and precautions. Alternative treatments are also discussed.įamilies are fully informed about VNS therapy before embarking on this form of treatment. The child's seizure history, prior and current treatments, behaviour and past medical problems need to be reviewed. What is involved prior to vagus nerve stimulation?Ĭhildren require referral from their neurologist or paediatrician to an epileptologist at the RCH for assessment of suitability. What does a vagus nerve stimulator look like? In Australia, more than 750 patients have been implanted. More than 125,000 patients globally have been implanted with VNS devices. VNS devices have been implanted in patients for over 25 years. The first implant in Australia was in 1994 and regulatory approval by the Therapeutic Goods Administration (Australia) was granted in April 2000. Regulatory approval as an adjunct therapy in reducing seizure frequency was granted in 1994 in Europe and 1997 in USA. The first VNS device was implanted in 1988 in the United States of America. About 80% of the nerve fibres in the left vagus nerve are input fibres transmitting, from the body to the brain, and the output fibres have minimal heart connections, making the left vagus nerve a suitable "wire" into the brain. Input nerve fibres transmit sensations and electrical feedback from the heart, lung, stomach and upper bowel to the brain. Output nerve fibres control muscles responsible for swallowing, coughing and voice sounds. The vagus nerve is one of the cranial nerves, meaning a nerve that is connected directly to the brain. Assessment by a paediatric neurologist experienced in comprehensive epilepsy management, including surgery, and VNS therapy is a prerequisite. VNS therapy is generally considered for children with epilepsy which significantly affects the life of the child and family, is not adequately controlled by antiseizure medication, and is not treatable with surgery. Who is suitable for vagus nerve stimulation? VNS therapy works differently to antiseizure medications and dietary treatments. It is not fully understood how VNS therapy works, but the theory is that the VNS over time modulates nerve pathways involved in seizures. This gives extra stimulation at pre-programmed settings. In addition, the pulse generator can be manually activated in between programmed stimulation times by the child or caregiver, by placing a provided magnet over the pulse generator and then removing it. ![]() It is individually programmed to automatically stimulate in the background, typically ON for 30 seconds and OFF for 3 minutes. The pulse generator is programmed to stimulate in two ways. Vagus nerve stimulation (VNS) is a treatment for uncontrolled epilepsy. VNS therapy reduces the frequency and severity of epileptic seizures in some children. VNS therapy involves insertion of a pulse generator, similar to a heart pacemaker, under the skin on the chest that sends intermittent electrical signals to the brain by stimulating the left vagus nerve in the neck. What is the cost of a vagus nerve stimulator?.Precautions with vagus nerve stimulation.What side effects or problems can occur?.What happens during the admission for insertion?.What is involved prior to vagus nerve stimulation?.What does a vagus nerve stimulator look like?.Who is suitable for vagus nerve stimulation?.
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