Vagus nerve stimulation is a procedure that uses an implanted device — much like a pacemaker — to stimulate the brainstem to distribute messages to the brain and then to the body’s organs. During vagus nerve stimulation, the implanted stimulator delivers intermittent, low-level electrical pulses to the vagus nerve in the neck. By a mechanism that is not completely understood, these impulses may travel to the brain centers controlling an assortment of health issues.
Vagus nerve stimulation is most often used to treat epilepsy when seizures are unresponsive to medication and considered “refractory” or “intractable.” The treatment is also being tested to treat a number of other conditions, including:
Multiple sclerosis (MS). A disabling central nervous disease, MS interrupts information flow between the brain and the body.
Alzheimer’s disease. This severe form of dementia causes progressive memory, thought and behavior issues that interfere with activities of daily living.
Cluster headaches. Usually affecting only one side of the head, cluster headaches is severe pain that recurs frequently during a several-week period.
Depression. Depression is a long-term psychological condition that negatively impacts a person’s actions, feelings and thought.
The procedure to implant the device usually takes place under general anesthesia and takes between 45 and 90 minutes. The neurosurgeon will make small incisions in the chest and implant a stimulator just under the skin, and wires from the stimulator are connected to the left vagus nerve. Once activated, usually in the doctor’s office two to weeks later, the device uses electrical signals sent through the vagus nerve to signal brain although, in some cases, it may be activated immediately in the operating room after implantation.
The strength and duration of the electrical impulses from the implant are calibrated. The amount of stimulation varies depending on the patient’s need, but is usually initiated at a low level and slowly increased to a suitable level for the individual. The device runs continuously and is programmed to turn on and shut off for specific periods of time.
Patients are given a hand-held magnet to use at home. When the magnet is swept over the pulse generator site, extra stimulation is delivered regardless of the treatment schedule.
Why Temple Health?
The Comprehensive Epilepsy Center at Temple Neurosciences offers a highly skilled, multidisciplinary medical team that includes neurologists, neurosurgeons, neuropsychologists, nurse coordinators and rehabilitation specialists who provide a complete range of diagnostic and treatment options designed to provide patients from teens to adulthood with the highest standard of care.
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