Having The VNS Implanted

People who plan to receive VNS Therapy must have the Pulse Generator and Bipolar Lead surgically implanted and the settings monitored and adjusted as necessary by a Doctor.

Surgery

Surgery lasts from about 45 minutes to two hours and typically involves general anesthesia, though local anesthesia is some time used. You will probably stay over night in hospital.
The surgeon makes a small incision below the collarbone in the chest or armpit for the Pulse Generator, which is then placed in a surgically made ‘pocket’. A second small incision is made in the neck for the Bipolar Lead, which is then attached to the left vagus nerve in the lower side of the neck and to the Pulse Generator under the skin.
The procedure is fully reversible in the event a patient decides to have the system removed.

Follow –up

The Pulse Generator is usually activated two weeks after surgery. At that time the Doctor will program the Pulse generator to the appropriate settings for the patient.
Then and during each visit afterward the doctor will check the system to make sure that it is working properly and that the treatment is not uncomfortable for the patient. It is recommended that patients see their Doctor at least once every six months. Patients with the device are given a Patient Emergency Information Card, which should be carried at all times.

Anti epileptic Medication

People who use VNS Therapy should always continue to take their same anti epileptic medications while receiving stimulation, for at least the first three months after implantation. After three months, follow the instructions of your Doctor regarding your medications.

How Vagus Nerve Stimulation Works

Vagus nerve stimulation is the first new approach to the treatment of epilepsy in more than 100 years and the first anti epileptic therapy to use an implantable device.
The Pulse Generator sometimes called a stimulator is similar to a cardiac pacemaker. It is computer controlled and battery powered. It sends signals through the electrodes and the Bipolar lead to the brain by way of the left vagus nerve to reduce the frequency and duration of seizures.

The Pulse Generator is implanted under the skin on the left side of the upper chest.
The Bipolar lead, a flexible, insulated tube housing the electrodes, is attached to the left vagus nerve on the left side of the neck.

The Pulse Generator and Bipolar lead are implanted during a procedure that generally lasts from about 45 minutes to two hours.
Later the Doctor programs the Pulse Generator to deliver stimulation automatically, 24 hours a day. During routine outpatient appointments, the Doctor can read and adjust stimulation settings using the computer, the software and the Programming Wand.

After implantation a NCP Magnet can be used to activate the stimulation whenever necessary, in addition to the automatic, programmed stimulation.

The Pulse Generator at typical settings can last between 6.6 and 10 years.
The Doctor will set the Pulse Generator to stimulate automatically seven days a week 24 hours a day. The typical setting cycle is usually 30 seconds ON and five minutes OFF. Although different setting may be used.

What is the aim of VNS?

VNS aims to reduce the number, length and / or severity of seizures. For some people their seizures become much less frequent, for others it may reduce their seizures a little, and for others it has no effect. For some people VNS reduces the length or intensity of their seizures, but this does not happen for everyone. It may also reduce the time it takes to recover after a seizure. It is unlikely to completely stop seizures and it does not ‘cure’ epilepsy.

The effect of VNS does not happen straightaway; it can take up to 2 years for it to have an effect on someone’s seizures. VNS is used alongside anti-epileptic drugs (AEDs) not instead of them. If VNS works, it may be possible to reduce a person’s anti-epileptic drugs over time.

Can I be considered for VNS?

VNS is usually considered if you have tried a number of anti epileptic drugs which have not fully controlled your seizures, and if you are not suitable for, or do not want to have, brain surgery. People who are considering VNS will usually be given information about VNS from their neurologist or epilepsy specialist nurse.

What can VNS do during a seizure?

Some people have a warning or aura - a type of simple partial seizure - that tells them that they are going to have a seizure. When this happens, passing a special magnet over the stimulator gives extra stimulation. This may stop the aura from developing into another seizure, or may reduce the length / severity of the seizure, or the recovery time afterwards. This magnet can be worn on your wrist like a watch, or on your belt.

For people who have no warning before a seizure, someone else could use the magnet when a seizure happens. (See magnet use)

Does VNS have any side effects?

VNS can cause side effects but usually only during the time that the nerve is being stimulated. Side effects may not happen for everyone but include discomfort in the throat, a cough, difficulty swallowing and a hoarse voice.

Side effects usually reduce over time and do not usually mean that the VNS has to be switched off. Your doctor or nurse can adjust the settings if the side effects are a problem to you. If the side effects cause problems at certain times, such as difficulty swallowing when you are eating, then holding the magnet over the stimulator for a few seconds briefly stops the stimulation, which should stop the side effects. VNS does not affect, and is not affected by, anti-epileptic drugs.

Does VNS have any other positive effects?

It can take up to 12 months to see how the VNS is working, and this varies from one person to another. Some people have significantly fewer seizures, while others may have a smaller reduction. Some people also find that VNS reduces the length or intensity of their seizures. Others find that VNS has no effect on their epilepsy. Very few people with VNS become completely seizure free.

Some people feel that VNS has a positive effect on their quality of life by enhances their moods, memory and / or alertness. For some it may also help reduce depression. Cyberonics who manufacture the devise are currently looking at alternative uses of VNS, including Clinical Depression. For more information go to www.vnstherapy.eu

What happens if VNS does not work for me?

VNS does not work for everyone. If after 2 years there is no improvement in your seizures, you might like to talk to your specialist about having the stimulator switched off or removed. Even if the VNS has no effect on your seizures, it might have other positive effects.

If you have any queries regarding VNS Therapy you can also contact the company direct by phoning 0800-046-1355


Please note:
Every effort is made to ensure that all our information is correct and up to date.

Some information may change after web publication. This information is not intended to be a substitute for medical guidance from your own doctors or specialist nurses.

 

 

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