scholarly journals Vagus nerve stimulator in patients with epilepsy: indications and recommendations for use

2013 ◽  
Vol 71 (11) ◽  
pp. 902-906 ◽  
Author(s):  
Vera C Terra ◽  
Ricardo Amorim ◽  
Carlos Silvado ◽  
Andrea Juliao de Oliveira ◽  
Carmen Lisa Jorge ◽  
...  
Keyword(s):  
Refractory Epilepsy ◽  
Palliative Surgery ◽  
Nerve Stimulator ◽  
Neurologic Disorder ◽  
Palliative Procedure ◽  
Spontaneous Seizures ◽  
Vagus Nerve Stimulator ◽  
Low Incidence ◽  
Patients With Epilepsy ◽  
Medically Refractory Epilepsy

Epilepsy comprises a set of neurologic and systemic disorders characterized by recurrent spontaneous seizures, and is the most frequent chronic neurologic disorder. In patients with medically refractory epilepsy, therapeutic options are limited to ablative brain surgery, trials of experimental antiepileptic drugs, or palliative surgery. Vagal nerve stimulation is an available palliative procedure of which the mechanism of action is not understood, but with established efficacy for medically refractory epilepsy and low incidence of side-effects. In this paper we discuss the recommendations for VNS use as suggested by the Brazilian League of Epilepsy and the Scientific Department of Epilepsy of the Brazilian Academy of Neurology Committee of Neuromodulation.

P.020 Septo-optic dysplasia plus manifesting with medically refractory epilepsy

2016 ◽  
Vol 43 (S2) ◽  
pp. S26-S26
Author(s):  
MO Al.Khateeb ◽  
S Mirsattari ◽  
D Diosy ◽  
R McLachlan
Keyword(s):  
Refractory Epilepsy ◽  
Intractable Epilepsy ◽  
Nerve Stimulator ◽  
Vagus Nerve Stimulator ◽  
Malformation Of Cortical Development ◽  
Functional Hemispherectomy ◽  
London Health ◽  
Epilepsy Monitoring ◽  
Video Eeg ◽  
Medically Refractory Epilepsy

Background: Septo-Optic Dysplasia is a rare disorder with developmental malformations that was first reported by De Morsier.SOD associated with refractory epilepsy has not been well studied. We report six cases with SOD in patients with malformation of cortical development(MCD) and medically refractory epilepsy that underwent video-EEG telemetry. Methods: Six cases of SOD plus were admitted to the Epilepsy Monitoring Unit at London Health Sciences Centre because of medically refractory epilepsy. Functional hemispherectomy in one patient resulted in significant reduction of her seizures while insertion of a vagus nerve stimulator was not successful in controlling seizures in another patient. Right temporal resection for one patient resulted in about 60% reduction in her seizures. The remaining three patients were not surgical candidates and they remained on antiepileptic drugs. Results: MCD was present in 4/6 patients. Bilateral optic nerve hypoplasia was found in 50% of the patients. EEG was abnormal in all cases(6/6).Intractable epilepsy was found in 6/6 patients. Conclusions: SOD plus was associated with medically refractory epilepsy.

scholarly journals Neuromodulation in refractory epilepsy: Brazilian specialists consensus

2016 ◽  
Vol 74 (12) ◽  
pp. 1031-1034
Author(s):  
Vera Cristina Terra ◽  
Isabella D’Andrea-Meira ◽  
Ricardo Amorim ◽  
Francisco Arruda ◽  
Andrea Julião de Oliveira ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Refractory Epilepsy ◽  
Epileptic Seizures ◽  
Palliative Surgery ◽  
Therapeutic Approaches ◽  
Brain Disorder ◽  
Medically Refractory Epilepsy ◽  
Deep Brain

ABSTRACT Epilepsy is a potentially devastating brain disorder characterized by a predisposition to spontaneous epileptic seizures. In patients with medically refractory epilepsy, new non-pharmacological therapeutic approaches may be considered. In this scenario, palliative surgery such as vagus nerve stimulation (VNS) or deep brain stimulation (DBS) may be indicated in a subset of patients. In this paper we make recommendations for the use of VNS and DBS in patients in Brazil with refractory epilepsy.

scholarly journals 0874 SLEEP DISORDERED BREATHING IN CHILDREN WITH REFRACTORY EPILEPSY TREATED WITH VAGUS NERVE STIMULATOR

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A324-A325
Author(s):  
S Hantragool ◽  
C Carosella ◽  
T Dye ◽  
N Simakajornboon
Keyword(s):  
Vagus Nerve ◽  
Sleep Disordered Breathing ◽  
Refractory Epilepsy ◽  
Nerve Stimulator ◽  
Vagus Nerve Stimulator ◽  
Disordered Breathing

scholarly journals Corpus Callosotomy for Intractable Epilepsy Revisited: The Children’s Hospital of Michigan Series

2017 ◽  
Vol 32 (7) ◽  
pp. 624-629 ◽  
Author(s):  
Aimee F. Luat ◽  
Eishi Asano ◽  
Ajay Kumar ◽  
Harry T. Chugani ◽  
Sandeep Sood
Keyword(s):  
Vagus Nerve ◽  
Intractable Epilepsy ◽  
Endoscopic Approach ◽  
Seizure Outcome ◽  
Nerve Stimulator ◽  
Corpus Callosotomy ◽  
Seizure Reduction ◽  
Palliative Procedure ◽  
Vagus Nerve Stimulator ◽  
Drug Resistant Epilepsy

Corpus callosotomy is a palliative procedure performed to reduce the severity of drug-resistant epilepsy. The authors assessed its efficacy on different seizure types in 20 subjects (age range 5-19 years); 8 with active vagus nerve stimulator. Fifteen had complete callosotomy, 3 had anterior 2/3, and 2 had anterior 2/3 followed later by complete callosotomy. Ten had endoscopic approach. In all, 65% had ≥ 50% reduction of generalized seizures leading to falls (atonic, tonic, myoclonic); 35% became seizure-free (follow-up period: 6 months to 9 years; mean 3 years). Seizure outcome distribution was better for generalized than for partial seizures ( P = .003). Endoscopic approach was as effective as transcranial approach. Seven subjects who failed vagus nerve stimulator therapy responded with ≥50% seizure reduction. Corpus callosotomy is an effective treatment for intractable generalized epilepsy leading to falls with significant seizure reduction or even elimination of seizures, in the majority of children.

Complete removal of vagus nerve stimulator generator and electrodes

2010 ◽  
Vol 5 (2) ◽  
pp. 191-194 ◽  
Author(s):  
Martin Ortler ◽  
Claudia Unterhofer ◽  
Judith Dobesberger ◽  
Edda Haberlandt ◽  
Eugen Trinka
Keyword(s):  
Vagus Nerve ◽  
Vagus Nerve Stimulation ◽  
Palliative Treatment ◽  
Refractory Epilepsy ◽  
Complete Removal ◽  
Nerve Stimulator ◽  
Left Behind ◽  
Vocal Cord Paresis ◽  
Vagus Nerve Stimulator ◽  
Microsurgical Techniques

Vagus nerve stimulation has become widely used in the palliative treatment of refractory epilepsy. Removal of a vagus nerve stimulator may be desirable or even necessary due to lack of efficacy, intolerable side effects, signs of infection, or failure of the device. Unless the lead or the helical electrodes are defective, only the generator is explanted and the electrodes are usually left behind for fear of damaging nerve or surrounding structures. The authors review their experience with complete removal of the stimulating electrodes and pacemaker-like generator device in 9 consecutive patients, 3 of whom were children. Using microsurgical techniques, the authors were able to completely remove the stimulator, including electrodes in all patients. All nerves remained morphologically intact. One case of temporary and one of permanent clinically silent ipsilateral vocal cord paresis were observed.

Brain Stimulation for Medically Refractory Epilepsy

US Neurology ◽  
2015 ◽  
Vol 11 (01) ◽  
pp. 57
Author(s):  
Donald L Schomer ◽  
Keyword(s):  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Refractory Epilepsy ◽  
Nerve Stimulator ◽  
Vagal Nerve Stimulator ◽  
Short And Long Term ◽  
Long Term Consequences ◽  
Patients With Epilepsy ◽  
Neural Stimulator

Every physician’s treatment goal for patients with epilepsy is to control or stop their clinical seizures with minimal to no short- or long-term complications. Medications are often effective in controlling seizures but have both short- and long-term consequences. Brain stimulation, with devices that include the vagal nerve stimulator, the responsive neural stimulator, and transcranial magnetic stimulation, offers additional potential for a therapeutic clinical response with significantly fewer short- and long-term side effects. These types of brain stimulators are discussed below.

Consequences of mesial temporal sparing temporal lobe surgery in medically refractory epilepsy

2021 ◽  
Vol 115 ◽  
pp. 107642
Author(s):  
Lilach Goldstein ◽  
Mitra Dehghan Harati ◽  
Kathryn Devlin ◽  
Joseph Tracy ◽  
Maromi Nei ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Refractory Epilepsy ◽  
Medically Refractory Epilepsy
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