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Vagus nerve stimulation (VNS) is another form of treatment that may be tried when medications fail to stop seizures. It is currently approved for use in adults and children over the age of 12 who have partial seizures that resist control by other methods. The therapy is designed to prevent seizures by sending regular small pulses of electrical energy to the brain via the vagus nerve, a large nerve in the neck.

The energy is delivered by a flat, round battery, about the size of a silver dollar, which is surgically implanted in the chest wall. Thin wires (electrodes) are threaded under the skin and wound around the vagus nerve in the neck. The battery is programmed by the health team to send a few seconds of electrical energy to the vagus nerve every few minutes. If the person with the system feels a seizure coming on, he or she can activate the discharge by passing a small magnet over the battery. In some people, this has the effect of stopping the seizure. It is also possible to turn the device off by holding the magnet over it.

Side effects of VNS treatment are mostly hoarseness and, sometimes, discomfort in the throat. There may be a change in voice quality during the actual stimulation. Although complete seizure control is seldom achieved, the majority of people who have the VNS implant experience fewer seizures. In some its effectiveness increases with time, and patients report an improved quality of life. As with surgery and the ketogenic diet, it may be necessary to continue with antiepilepsy medication in addition to VNS therapy.

Implanting the VNS battery in a patient and connecting it to the vagus nerve takes about an hour. It is usually done under general anesthesia, though local anesthesia is sometimes used. The operation can be done on an in-patient or out-patient basis.

The surgeon makes two small incisions — one in the neck to gain access to the vagus nerve, and one below the collarbone in the chest wall or armpit.

The surgeon places the VNS pulse generator into a surgically-made “pocket” under the skin of the patient’s chest and threads a plastic tube containing the electrodes from the neck to the generator in the chest. He or she then gently wraps the flexible ends of silicone-coated electrodes around the vagus nerve.

People who’ve had the VNS implant should let their doctors know if at any time the device becomes uncomfortable, if the stimulation seems to be coming on too often, or if it seems to have stopped altogether, or if they have any concerns about its operation or effects.

If necessary, the doctor will adjust how much stimulation is being delivered, and how often.

The doctor makes these adjustments with a computer, special software and a programming wand. Re-programming the VNS system is a painless procedure that takes only a few minutes in the doctor’s office.

The identical procedure is FDA approved for depression. Many epilepsy patients suffer from depression and VNS can potentially remedy both illnesses.

Charles Donovan was a patient in the FDA investigational trial of vagus nerve stimulation as a treatment for chronic or recurrent treatment-resistant depression. He was implanted with the vagus nerve stimulator in April of 2001. He chronicles his journey from the grips of depression thanks to vagus nerve stimulation therapy in his book:

Out of the Black Hole: The Patient’s Guide to Vagus Nerve Stimulation and Depression

His all inclusive book prepares depression sufferers to make an informed decision about this ninety-minute out-patient procedure. It is a “must read” before you discuss this treatment with your psychiatrist. A prescription for the procedure is required from an M.D. and it is covered by most insurance plans.

He is the founder of the http://www.VagusNerveStimulation.com Web Site and Bulletin.