Vagus nerve stimulation

Although antiseizure medications are the mainstay of treatment for LGS, there are non-pharmacologic adjunctive therapy options that are also available.1 One of them is called vagus nerve stimulation Passing electrical impulses along the vagus nerve to help control epileptic seizures. Short bursts of electrical energy are directed into the brain through the vagus nerve. The energy comes from a battery that is surgically implanted under the skin in the chest. (VNS). In this therapy, an implant sends small electrical impulses to the brain to help control seizures. This therapy option is not approved for the treatment of LGS in the United States.

The vagus nerve is a large nerve in the neck. In VNS, short bursts of electrical energy are directed into the brain through the vagus nerve. The energy comes from a battery-operated device that is surgically implanted under the skin—usually in the chest. The procedure takes 60-90 minutes with the patient under general anesthesia or local anesthesia.2,3

The battery-operated device is programmed to deliver small stimulations to the vagus nerve every few minutes,2 like a pacemaker for the brain. Holding a special magnet over the device can allow users to stimulate the vagus nerve as needed, such as when an "aura" occurs before a seizure.2

In VNS, short bursts of electric energy are directed into the brain to treat seizures.

VNS is used in addition to medicines

In 3 small, published studies, selected patients were given VNS therapy as adjunctive therapy in addition to antiepileptic medication. Approximately three-fourths of patients with LGS experienced more than a 50% reduction in seizure frequency with a follow-up period as long as 5 years.4

Side effects of VNS

VNS therapy may not be for everyone. It can often cause hoarseness during stimulation. Other common side effects include tingling in the throat, shortness of breath with exertion, cough, and headaches.3

Talk to your doctor to see what options are available for your loved one.

LGS (Lennox-Gastaut Syndrome) treatment options

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References:

  • 1. Hosain S, Nikalov B, Harden C, Li M, Fraser R, Labar D. Vagus nerve stimulation treatment for Lennox-Gastaut syndrome. J Child Neurol. 2000;15:509-512.
  • 2. Schachter SC, Sirven JI. Vagus nerve stimulation (VNS). Epilepsy Foundation Web site. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/vagus-nerve-simulation-vns. Updated March 2018. Accessed December 1, 2019.
  • 3. Mayo Clinic Staff. Vagus nerve stimulation. Mayo Clinic Web site. http://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/details/risks/cmc-20167760. Accessed December 1, 2019. 
  • 4. Cherian KA. Lennox-Gastaut syndrome. Medscape Web site. https://emedicine.medscape.com/article/1176735-print. Updated November 2018. Accessed December 1, 2019.