Similar to a pacemaker, a stimulator device for epilepsy is implanted under the skin, either near your collarbone or on your skull. A wire (lead) under the skin connects the device to electrodes implanted in your brain or attached to nerves that go to your brain. The doctor programs the device either to produce weak electrical signals that travel to your brain at regular intervals or to notice abnormal electrical activity in the brain and send electrical signals to that area of the brain. These signals help prevent the electrical bursts in the brain that cause seizures.
What To Expect After Treatment
The nerve stimulator can start working right after the surgery. You may notice a slight bulge in the area where the device is. And the surgery will leave small scars where the wire leads were placed and where the device was implanted.
Why It Is Done
Nerve stimulation can be used in some people who have generalized or partial seizures, who have not responded well to antiepileptic medicines, and who are not candidates for epilepsy surgery.
Nerve stimulation is used in combination with other treatment. Nerve stimulation does not eliminate the need for medicine. But it can help reduce the risk of complications from severe or repeated seizures.
How Well It Works
Most of the evidence supports the use of vagus nerve stimulation. It reduces the frequency of seizures that don't respond well to medicine and may make them less severe. About 2 out of 4 people say they notice that they have fewer seizures after surgery. But about 1 out of 4 people say they do not notice any benefit after surgery.1
The benefits of VNS seem to increase over time.
For people who can sense when they are about to have a seizure, turning on the VNS using their hand-held magnet can sometimes prevent the seizure. It may also shorten a seizure already in progress.
Studies show that VNS may also be effective in children.1
Nerve stimulation is considered safe. Side effects occur in some people when the device stimulates the nerve. They include:
- Throat pain.
- Hoarseness or slight voice changes.
- Shortness of breath.
Other risks of nerve stimulation have to do with the surgery to place the electrodes and the stimulator, including:
- Numbness or tingling.
- Pain where the stimulator device is placed under the skin.
Depression and memory impairment (with deep brain stimulation, or DBS).
What To Think About
Nerve stimulation is not a cure for epilepsy, and it does not work for everyone. It does not replace the need for antiepileptic drugs. It is most likely to be available at an epilepsy center.
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Englot DJ, et al. (2011). Vagus nerve stimulation for epilepsy: A meta-analysis of efficacy and predictors of response. Journal of Neurosurgery, 115(6): 1248-1255.
Primary Medical ReviewerJohn Pope, MD - Pediatrics
Specialist Medical ReviewerSteven C. Schachter, MD - Neurology
Current as ofMarch 12, 2014