Epilepsy is known to be the world’s fourth most common neurological disorder. Surges of electrical activity in the brain might trigger periodic seizures if you have epilepsy. It produces unprovoked seizures on a recurring basis.
If you have two unprovoked seizures or one unprovoked seizure with a significant risk of additional ones, your doctor may diagnose you with epilepsy. However, epilepsy is not the cause of all seizures. Seizures can be caused by a brain injury or a genetic feature, although the reason is often unknown.
The term “epilepsy” merely means “seizure disorders,” and it says nothing about the source or severity of the seizures.
What is Vagus Nerve Stimulation (VNS)?
One of the known treatments for epilepsy is Vagus Nerve Stimulation (VNS). It is an add-on therapy for adults and children four years and older. It’s approved by the U.S. Food and Drug Administration (FDA) to treat focal or partial seizures that don’t respond to seizure medicines. Drug-resistant epilepsy is also known as refractory epilepsy.
The vagus nerve connects the sides of the neck to the brain and extends from your brainstem through your neck to your chest and abdomen on each side of your body.
In VNS, a small device similar to a pacemaker is employed to stimulate the vagus nerve with electrical impulses to treat either epilepsy or depression. Electrical pulses are sent from the VNS to the nerve, which then transports them to the brain. This aids in the prevention or shortening of seizures.
A device is surgically placed under the skin on your chest, and a wire is put under your skin to attach the device to the left vagus nerve in traditional vagus nerve stimulation. When the gadget is turned on, it transmits electrical signals to your brainstem, which subsequently sends messages to certain sections of your brain. The right vagus nerve isn’t employed because it’s more likely to transport fibers that provide nerves to the heart.
In Europe, non-invasive vagus nerve stimulation devices that do not require surgical implantation to treat epilepsy, depression, and pain have been approved. In the United States, the Food and Drug Administration recently approved a non-invasive device that stimulates the vagus nerve to treat cluster headaches.
How Can It Help a Person with Epilepsy?
VNS is a type of neuromodulation made to change the way brain cells work by stimulating certain parts of the brain that cause seizures.
The vagus nerve is part of the autonomic nervous system, which regulates bodily functions that are not controlled by the conscious mind (such as heart rate and breathing). The nerve connects the brain to the rest of the body and transports data from the brain to the body.
VNS has been shown in studies to help control seizures by:
- Improving blood flow to critical brain locations
- Increasing the levels of neurotransmitters, which are critical for seizure management.
- During a seizure, changing EEG (electroencephalogram) patterns
- Before a seizure, 8 out of 10 patients with epilepsy may experience an increase in heart rate.
- A quick increase in heart rate can be detected in the newest VNS devices (AspireSR® and SenTivaTM). This causes an additional burst of stimulation, which helps to end the seizures.
- These models could be especially useful for persons who are unaware of when they have seizures, if they are not witnessed, or if they happen at night.
While VNS therapy does not cure epilepsy, it’s designed to help control or lessen the number and severity of seizures.
In the first three months of VNS therapy, people have reported an average decrease in seizures by 28%. More data from a study of 65 people who had VNS for ten years or more showed improvements or decreases in seizures as follows:
- 36% after 6 months
- 58% after 4 years
- 75% after 10 years of having the VNS device implanted.
Other results of studies showed:
- Shorter recovery time after a seizure for some people
- Improved quality of life
- Reports of less worry about seizures
- Less severe episodes
Takeaway
While anti-seizure (or anti-epileptic) medications have shown to be particularly effective in most epilepsy clinical trials, the VNS is an option if medications alone fail to control the seizures. It may take your doctor a few tries to find the right courses of treatment, be it with a drug or through VNS.
An epilepsy specialist would go over the medications you’ve tried to ensure you’ve tried the proper ones for the right kind of seizures. And put them to the test for an extended period.
When considering VNS, it is best to see a comprehensive epilepsy center first to ensure that all options have been exhausted and that the VNS therapy is appropriate for you.
Make an appointment with an epilepsy specialist to discuss this and other treatment alternatives.