Vagus nerve stimulation has been shown to significantly decrease both the number and severity of seizures, often used as part of treatment plans for epilepsy or depression that has proven refractory.
The vagus nerve, also known as Cranial Nerve X, is one of the 12 pairs of cranial nerves responsible for sending electrical signals throughout your head and neck. Part of your parasympathetic nervous system, which controls various body functions.
How Does VNS Work?
The vagus nerve serves as the main connection between your brain and digestive tract. Extending from your brain through neck, chest and abdomen into gut, this nerve connects with nearly all organs for digestion, heart rate, breathing, immune function as well as mental wellbeing. Studies indicate that stimulating vagus nerve can improve both mental and physical wellbeing.
In 1997, the FDA first approved an implanted VNS device to treat refractory epilepsy and later used in clinical trials for treating depression. It works by sending regular electrical pulses directly to your vagus nerve through a pacemaker-style pulse generator; its lead wire travels under your skin towards your left neck where it connects directly with the nerve via another incision. Battery power keeps this device running for years before needing replacing with new batteries or recharged.
As part of an initial medical visit after surgery, a pulse generator is turned on and gradually increased until you reach the optimal dosage for you. Stimulation doesn’t cause pain but may feel like tingling or slight vibration; sessions typically last 30 seconds at a time and then fade off for five minutes at a time; its cycle can also be manually turned off with magnets if required.
Some newer VNS devices can detect sudden heart rate increases that could indicate an impending seizure, sending extra stimulation bursts to help prevent it. They can also be activated by those experiencing aura warnings to help stop seizure before it starts.
Other commercial or external VNS devices may help stimulate the vagus nerve without surgery, though their frequency and voltage don’t match the specific activity of your vagus nerve and can lead to unexpected side effects like hoarseness or difficulty swallowing.
What Are the Benefits of VNS?
VNS can improve your quality of life by decreasing the frequency, duration and severity of seizures as well as decreasing your need for anti-seizure medications. With less seizures occurring every day and reduced anti-seizure reliance this treatment allows more focus to be put toward daily activities; increasing confidence to engage in more social events, work tasks or other endeavors while improving mood and reducing anxiety, irritability or depression.
VNS therapy has been shown to boost the brain’s natural chemical messengers and create an overall feeling of wellbeing, including better emotions regulation and reduced inflammation and heart rate improvements. Furthermore, VNS can even ease rheumatoid arthritis symptoms by lowering inflammation markers.
VNS should be used with caution and should never be seen as a complete cure for epilepsy or seizures, nor will it improve all symptoms of depression; nor is it effective in every individual. If unsure, discuss VNS with your physician to see if it could benefit you.
Implanted devices send electrical pulses directly into your vagus nerve, which travels to your brain. This stimulation can be used to treat various conditions including seizure disorders like refractory epilepsy and depression as well as those related to stress such as autoimmune diseases or heart disease.
Your neurologist will be able to explain the advantages of VNS for treating your condition and provide more details about its operation. They’ll also ensure the device is functioning as it should be and assess any wound sites before adjusting your settings to reach a level which usually helps alleviate symptoms effectively.
People with implanted VNS devices can activate it by passing a magnet over the pulse generator in their chest area, activating an extra burst of electricity that sends extra shocks through. This may help relieve warnings (auras) prior to seizures and potentially stop them altogether; additionally, VNS may improve quality of life by helping people feel more calm – and is less invasive than many treatments available today.
What Are the Side Effects of VNS?
The vagus nerve is one of 12 pairs of cranial nerves running along the neck, providing involuntary body functions like breathing, heart rate and digestion under voluntary control. According to medical theory, stimulating this nerve may disrupt abnormally synchronous brain activity that leads to seizures as well as alter certain brain chemicals responsible for mood regulation. VNS therapy has been approved by FDA as an adjunct therapy in stroke-related depression patients as well as for other neuropsychiatric conditions.
Surgery to implant an artificial device involves general anesthesia for patient comfort. To place it under, bipolar leads are tunneled under the skin connecting an approximately silver dollar-sized implant device to electrodes on the left vagus nerve in the neck. After programming with handheld magnets to customize stimulation parameters.
People treated with VNS typically see a reduction of seizure frequency by as much as 50% and require anti-seizure medication less frequently for reduced seizure activity. They may also notice their seizures are less severe and don’t last as long, possibly decreasing overall treatment costs and time needed.
Some individuals using VNS experience an improvement in their mental health. Studies show that VNS therapy can help regulate depression symptoms by altering neurotransmitter production and changing activity in areas of the motor cortex responsible for movement control in their brains.
After surgery, patients must return regularly for monitoring and adjustment of device settings by their neurologist. As part of this titration process, pulse intensity gradually increases over time (usually 0.25mA per visit) until reaching an effective setting; antiseizure medication dosage remains unaltered during this titration process.
At these appointments, a doctor will evaluate the wound site and make sure the device is functioning effectively. Some people experience hoarseness or tickling sensations in their throat or chest when activating their device; these side effects typically subside with use.
Before scheduling any imaging tests (like magnetic resonance imaging) that could interfere with their implant device, they should contact their insurance company as well as notify any travel plans.
What Are the Risks of VNS?
The vagus nerve is one of twelve cranial nerves and connects your brain with various parts of your body, such as your heart. Researchers are exploring its use for treating depression, migraines and seizures as well.
Doctors do not yet fully understand how VNS works, but they believe triggering the vagus nerve will send electrical energy up into a wide area of your brain to disrupt any unusual brain activity that might lead to seizures and trigger it into producing chemicals that reduce seizure activity.
VNS doesn’t cure epilepsy and most people will still require anti-seizure medication; however, it may reduce seizures’ frequency, length, severity and auras – providing some people with warnings before their seizure begins allowing them to activate VNS with magnet when this occurs and possibly shorten or stop it entirely.
Surgery to implant VNS devices is generally safe and quick for most people who receive them, with potential risks including infection as well as possible pain or inflammation at the incision site and possible damage to vagus nerve structures and potential issues with pacemakers (devices which pulse electricity). A recent study involving 247 VNS implant recipients between 1990 and 2014 found 8.6% experienced surgical complications while hardware complications (like broken pacemaker wires or infected nerves) occurred in 3.7%.
Some side effects from VNS may be minor and gradually dissipate over time, while others can have more significant implications on your quality of life – these could include chest or throat discomfort, coughing or hoarseness as well as the potential risk of stroke or heart failure caused by this device. Furthermore, VNS could trigger your autonomic nervous system to produce certain chemicals which regulate blood pressure and breathing.
Commercial devices available on the market that stimulate the vagus nerve are not as rigorously tested as clinical ones, nor can they precisely target vagus nerve fibers that carry signals between organs and your brain. Instead, commercial devices may excite smaller nerves that convey pain rather than stimulating these messages directly to the brain as intended by physicians.
