Vagus nerve stimulation therapy in epilepsy
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Last updated 25 Aug 2010, review date due 25 Aug 2011
This page is about vagus nerve stimulation in the UK. If you are looking for information in other countries, please contact your local epilepsy group who may be able to help.
Contents
- Introduction
- About vagus nerve stimulation (VNS) therapy
- About the operation
- Living with the vagus nerve stimulation (VNS) therapy
- Availability of vagus nerve stimulation
- Support organisation
Our thanks
Epilepsy Action would like to thank Lynn Greenhill, Epilepsy Nurse Specialist and Honorary Lecturer, Birmingham, UK, for reviewing this information.
Introduction
This fact sheet explains what vagus nerve stimulation therapy is (commonly known as vagus nerve stimulation or VNS) and how it can help some people with epilepsy.
About vagus nerve stimulation (VNS) therapy
What the vagus nerve stimulation therapy is
Vagus nerve stimulation (VNS) therapy uses a small generator that is implanted under the skin below the collar bone. This is connected to a lead with two coils at one end. These coils are wrapped around the vagus nerve at the side of the neck, under the skin, during a small operation.
The generator sends electrical impulses, at intervals, to the vagus nerve and then to the brain. This helps to lessen how often the seizures happen and how severe the seizures are.
How vagus nerve stimulation works
The generator is programmed (during the operation) to send electrical impulses, at intervals throughout the day. The electrical impulses are sent through the lead, to the vagus nerve in the neck and then to the brain. This will help to prevent electrical activity that causes seizures.
If necessary, the generator can be adjusted after the operation, or at an outpatient appointment, by the doctor, or epilepsy nurse specialist.
While in hospital the person will be given a magnet that can also be used to activate the generator to send extra impulses through to the brain. The magnet works by passing it over the implanted generator.
This would be used if the person feels a seizure starting, or during a seizure. This can stop the seizure, shorten the seizure or lessen the severity of the seizure, in some people. The magnet can also be used by a carer, or family members, if they witness a seizure.
Seizure control with vagus nerve stimulation
After the VNS is implanted, it can take from a couple of months to up to two years to notice a difference in seizure control. Reported benefits include fewer seizures, occasionally seizure freedom, shorter seizures, quicker recovery after a seizure, feeling more alert and improved mood.
People who could benefit from vagus nerve stimulation
Vagus nerve stimulation is for people, of all ages, with difficult to control epilepsy. It’s suitable for any type of epileptic seizures. Around 55,000 people worldwide have been implanted with vagus nerve stimulators.
About the operation
What the operation involves
Two small cuts are made, one to implant the generator and another for the lead. This involves:
- an operation that lasts about one to two hours
- a cut in a natural crease on the left side of the neck for the lead
- a cut on the left upper chest near to the armpit for the generator
- a stay in hospital of around one or two days.
The risks of having vagus nerve stimulation operation
The vagus nerve stimulation (VNS) operation is straightforward and is now commonly done. However, there are risks for anyone who has any type of operation.
The VNS operation is usually done under a general anaesthetic. As with any type of operation, there is a slight risk of reaction to the anaesthetic. There is also a small risk of bleeding and infection with any type of operation. There can be other rare complications and the surgeon would give more information about the risks, before the operation takes place.
There may be some pain after VNS surgery, from the area of the implant. The doctor can prescribe something for this.
Living with the vagus nerve stimulation (VNS) therapy
The side-effects
The most common side-effects reported from the vagus nerve stimulation (VNS) implant are:
- temporary hoarseness/change in the voice tone
- sore/tickling throat
- shortness of breath
- coughing
- prickling feeling in the skin.
Anti-epileptic drugs after the implant
Anti-epileptic drugs (AEDs) should be taken as normal, for several months after the operation. The doctor will then give advice on any possible changes to the AEDs.
Replacing the generator
There is a tiny battery in the generator that can last for around six to 11 years. At some point, the battery will need replacing. The higher the frequency and output of the stimulation, the faster the battery will run down. Your doctor or nurse can tell when the battery is running down by reading the VNS therapy device. They will then arrange for a new battery in the generator to be implanted. This involves a small operation, which lasts less than an hour. It doesn’t usually mean an overnight stay in hospital.
Availability of the vagus nerve stimulation
In the UK vagus nerve stimulation is available to patients who are referred on the NHS, or privately. Details of implant centres and programming can be found on www.vnstherapy.co.uk, email website-info@cyberonics or from your family doctor or specialist.
Support organisation
F.A.B.L.E.
305 Glossop Road
Sheffield
S10 2HL
UK
Telephone 0114 2755 335
Freephone Advice Line 0800 521 629
Email fable@btconnect.com
www.fable.org.uk
Conflict of interest declaration
Lynn Greenhill has declared that she has received sponsorship from Cyberonics in the past. She attended the International League Against Epilepsy Congress representing Cyberonics in 2010.
Epilepsy Helpline
- UK freephone 0808 800 5050
- International +44 113 210 8850
- Email: helpline@epilepsy.org.uk
- Txt msg: 07797 805 390 info
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Epilepsy Action blog
Comments
hi ive just had the vns surgery done and i haent had it switched on yet but im positive it will make some kind of diffrence to my life and make my life a whole lot better even if it doesnt cure me fully.i have had the plasters/bandages taken of today also.having this operation has made my life alot easier i dont get to frustrated and i dont really get upset anymore.i think even though it hasnt been switched on i know what big diffrence it has made on me and will make on me so i also recomend that anyone with epilepsy should consider having this operation done.i didnt agree with it at first and it may hurt just a tincy bit but apart from that it will make a diffrence so just think about it.
i live in germany (hubbys in forces) & am goin in to hospital next wk for 1-2wks for tests to hopefully find out if vns therapy will b ok for me! iv lived with epilepsy for 21years & it has certainly messed my life up, cant go where u want, when u want, drive, keep a job, any light affects it so the cinema & clubbing is out! even gettin dressed is tricky. it has also made me suffer from serious depression so im keeping my fingers crossed that im ok for it & it works so i can get my life back on track after many years of floating aimlessly & volunteer work! i need some purpose back in my life!
Dear Jo,
Just thought I'd let you know my views on VNS. I had an implant in July 2009 and the difference it has made to my life is amazing! For over fifteen years I have been trying all types of medication but unfortunately none of them successfully controlled my seizures. I'd nearly given up hope and found myself very down due to the impact the epilepsy was having on my life. At first the VNS didn't seem to control the seizures but now after the device has been switched up three times it really has changed my life for the better. I've gained confidence, the scars are small and neat and if people ask or look at them it makes a great starting point for a conversation so I don't feel self-conscious at all. It's changed my family and friends' lives too as they aren't constantly worried anymore and I'm sure I'll be driving in a year or two. My consultant has decreased my medication dramatically which has also had a positive impact - I have much more energy now and can work well. The implant also seems to have cheered me up so I really would recommend it to everyone who suffers from such a frustrating illness. Good luck with getting your epilepsy under control and maybe you too could decrease your medication with help from your consultant so you won't be on tonnes anymore!
What have you got to lose? Try your best to think positively and weigh up the impact it could have on your family and friends if you do end up seizure-free.
Take care and good luck,
Kate
I have epilepsy and have many different types of it, so I am on tonnes of medication. I have been offered VNS surgery recently and have been told to think about it. I have heard the medical pros, but as yet no cons. I would really like to know how a normal person, who wears the device on a daily basis, feels about it! How have you coped? Has it helped for better, for worse? Do you feel self-conscious about it being noticable? If anyone can let me know, I'm sure I'm not the only one who has these worries. Thanks.
Hello. My name is Jo and I have a son with a chromosome abnormality called ring 20. He had the VNS device put in in september 07. Today we had another appointment up at Kings College and he is now on the rapid cycle, 30 seconds off - 7 seconds on. Up till now the device has not made any difference to my sons seizures. My husband and I are hoping that the cycle that our son is now on will help, but I'm not to sure, fingers crossed it will work, or cut them right down. Our son has several seizures a day, (some lasting about 30 - 40 mins, which is normal in ring 20) We will keep you posted.
congratulations in ur qualifications... I don't know how you've gone on, but i was always being put down off my consultant when i told him what i was studying; i am training to be a teacher, i am a lifeguard and swimming instructor, first aider, cub scout leader plus more. i was always told off my consultant I would never make it to these qualifications - but i did :)
they are applying for the funding for my VNS at the mo I am preying that they get it it's getting where my seizures are effecting me more that even and the side effects of tablets are just horendous - they tried every tablet for epilepsy up to now. i hope it makes the same difference to my life as it does to yours
i had my VNS implanted 2 years ago as at 20 years of age i was trying to study and my siezures were very frequent. At 22 I am now almost 12 months free of siezures and am due to qualify in my studies in september. the VNS has defenitely helped me, i have had a few problems with the adjustments of the intensity but to know that i now have control over my siezures is rewarding and i can finally consontrate on other aspects of my life.