Vagal Nerve Stimulation (VNS) is used to treat complex epilepsy. There are two Vagus nerves on each side of the body, but only the left is used for this procedure because the right Vagus nerve regulates cardiac activity. In patients with complex epilepsy that is not well controlled by antiepileptic medications, VNS is recommended.
What is it?
VNS corrects abnormalities originating from nerve activity within the brain. In this procedure, a pacemaker implanted in the chest connects to a wire leading to the vagus nerve, allowing neurosurgeons to send electrical impulses to regulate different regions of the brain.
What should I do to prepare?
VNS is an elective procedure. Patients should discuss all treatment options with their doctor before undergoing VNS. Patients may be asked to discontinue certain medications. Patients may also be directed not to eat or drink before surgery.
What happens during the process?
First, the patient’s placed under general anesthesia for this procedure. The surgeon makes an incision in the upper-left side of the chest to implant the stimulator device. This device is designed to be permanent but can be removed if necessary. A second incision is made on the left side of the neck. A lead wire is connected to the stimulator, placed under the skin, and then wrapped around the Vagus nerve through a second incision. Following the surgery, the stimulator is activated in the doctor’s presence to ensure the patient tolerates the VNS impulses well. A computer regulates and sets the impulses, but the patient will also have a magnet to manipulate the device when they begin to experience a seizure. The magnet will activate the device, and either prevents or reduces the seizure.
What are the risks and potential complications?
Some risks and complications associated with this procedure include pain near the surgical sites or in the chest, excessive bleeding and infection, difficulty swallowing, vocal cord paralysis, breathing problems, reduced heart rate, and tingling or prickling of the skin.
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