Implant Device Helps Many Untreatable Epilepsy Patients
The only major side effect of the vagus nerve stimulation device is hoarseness and throat discomfort, which occurs because the nerve being stimulated also controls certain speech functions. However, this problem can be lessened by having the physician adjust the device so that less current is generated, DeGiorgio says.
Another study, done by Ravish V. Patwardhan, MD, a resident in the division of neurosurgery at the University of Alabama at Birmingham, and colleagues, shows that vagus nerve stimulation is also effective in children. Patwardhan's study involved implanting vagus nerve stimulation devices in 38 children, aged 11 months to 17 years. The researchers found that nearly two-thirds of the children treated with vagus nerve stimulation experienced a 50% or greater reduction in seizures.
One possible reason that children seem to do even better with vagus nerve stimulation than adults is that their brains have not had as much damage as older patients, who have suffered from epilepsy longer. "Patients who keep suffering from seizures have a poorer outcome than if the seizures are stopped," Patwardhan tells WebMD. "One patient had had seizures 15 years before the device was put in. That's probably too long to wait." Patwardhan presented his study in San Antonio, Texas, this week at a meeting of the Congress of Neurological Surgeons.
Gregory Barkley, MD, medical director of the Comprehensive Epilepsy Program at Henry Ford Hospital, in Detroit, cautions that despite the promising results, vagus nerve stimulation is not a cure for epilepsy. "It doesn't get you off of anti-seizure medications and it doesn't stop all seizures," he says. "It's more of a salvage procedure when nothing else works."
Patients diagnosed with epilepsy should first try medications to see if that will keep their epilepsy under control. If medications alone do not work, patients should be evaluated to see if they are good candidates for epilepsy surgery. Only if surgery is ruled out as a possibility should patients and their physicians consider vagus nerve stimulation, Barkley says.