Vagus Nerve Stimulator (VNS) Placement

The vagus nerve is a relatively large-diameter cranial nerve which exits the brain at the base of the skull and travels down the neck, giving off branches to the heart, stomach, intestines, and other organs.  It is a paired nerve, with one on the right side and one on the left side of the body.  Some of the vagal nerve fibers provide sensation to the airway, lungs, esophagus, stomach, and intestines.  Others control contractions of the intestine or secretions by the stomach or other abdominal organs.

Anatomy

Because the vagus nerve can be accessed in the neck, through a small incision, it has been utilized as a route to deliver electrical impulses to the body.  Instead of opening a hole in the skull to deliver electrical stimulation directly to the brain, surgeons can place electrodes on the vagus nerve in the neck, in order to allow electrical stimulation from small devices, called generators, to be delivered up through the neck to the base of the brain.

Use in Epilepsy

It has been discovered that, delivering small quantities of electricity in a specific frequency, via the vagus nerve, to the base of the brain can, in some patients, reduce the severity and frequency of partial-complex seizures.  This technology, originally studies in animals, was approved for use in humans by the United States Food and Drug Administration in 1997.  Surgeons in our department have been implanting VNS devices since 2001.  The device has also been found to be helpful in some cases of severe depression which is resistant to medication treatment.

Children with epilepsy which has failed to response adequately to maximal medical therapy may be candidates for VNS placement.  The decision on whether to consider such treatment should be made by the parents, patient, and the child's pediatric neurologist.  Once such a decision is made, our surgeons would be happy to discuss the surgical procedure with you in detail.