Question

Vagal nerve stimulation. [5]

Hint:

VNS can significantly reduce the frequency of seizures, though it may not eliminate them entirely. Regular follow-up is necessary to adjust settings and monitor effectiveness.

Answer 1

Vagal nerve stimulation (VNS) is a therapeutic option for patients with epilepsy who do not respond to medical management.
Step 1: Mechanism of Action:
VNS involves the implantation of a small device under the skin in the chest, which sends electrical impulses to the vagus nerve. These electrical impulses modulate the brain’s electrical activity, potentially reducing the frequency and severity of seizures.
Step 2: Indications:
1. Refractory Epilepsy: VNS is primarily used for patients with focal or generalized epilepsy who have not responded to antiepileptic drugs.
2. Patients Who Are Not Surgical Candidates: VNS can be an option for patients who are not candidates for surgical resection due to the location of the seizure focus or other contraindications.
Step 3: Procedure and Follow-up:
1. Implantation: The procedure involves placing an electrode around the left vagus nerve, which is connected to a pulse generator implanted in the chest.
2. Settings and Adjustment: The device is programmed to deliver electrical impulses at regular intervals, and settings may be adjusted periodically to optimize seizure control.