scholarly journals Responsive Vagus Nerve Stimulation for Drug Resistant Epilepsy: A Review of New Features and Practical Guidance for Advanced Practice Providers

2021 ◽  
Vol 11 ◽  
Author(s):  
Breanne Fisher ◽  
Julie A. DesMarteau ◽  
Elizabeth H. Koontz ◽  
Seth J. Wilks ◽  
Susan E. Melamed
Keyword(s):  
Vagus Nerve ◽  
Nurse Practitioners ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Physician Assistants ◽  
Healthcare Team ◽  
Advanced Practice ◽  
Drug Resistant ◽  
Clinical Nurse Specialists ◽  
Drug Resistant Epilepsy

Vagus nerve stimulation (VNS) is a safe and effective therapy that has been available for over 20 years for adults and children with drug resistant epilepsy (DRE). Since U.S. Food and Drug Administration approval in 1997, VNS has been implanted in over 100,000 patients including over 30,000 children as an adjunctive therapy in reducing the frequency of seizures in patients 4 years of age and older with focal seizures that are refractory to antiseizure medications. VNS Therapy® has evolved over time and currently offers closed-loop, responsive stimulation as well as advanced features that streamline dosing and patient management. Advanced Practice Providers (APPs) such as nurse practitioners, physician assistants and clinical nurse specialists are integral in a comprehensive healthcare team, and dedicated VNS clinics have formed at comprehensive epilepsy centers across the world that are often managed by APPs. This approach improves access, education, and continuity of care for those with VNS or those considering VNS. Here we provide a review for APPs on the VNS Therapy® system focused on new features, dosing, and troubleshooting strategies with the goal to provide guidance to those managing VNS patients.

Vagus nerve stimulation for drug-resistant epilepsy

2019 ◽  
Vol 20 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Laura Pérez-Carbonell ◽  
Howard Faulkner ◽  
Sean Higgins ◽  
Michalis Koutroumanidis ◽  
Guy Leschziner
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Therapeutic Option ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Randomised Controlled

Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%–40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.

scholarly journals Vagus nerve stimulation for pediatric patients with drug-resistant epilepsy caused by genetic mutations: Two cases

2020 ◽  
Vol 8 (3) ◽  
pp. 138-148
Author(s):  
Xiaoya Qin
Keyword(s):  
Vagus Nerve ◽  
Empirical Evidence ◽  
Therapeutic Effect ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Pediatric Patients ◽  
Genetic Mutations ◽  
Drug Resistant ◽  
Therapeutic Impact ◽  
Drug Resistant Epilepsy

Vagus nerve stimulation (VNS) is a neuromodulation therapy increasingly used for treating drug-resistant epilepsy. However, it remains to be determined which patients are best suited for the treatment, and it is difficult to predict the therapeutic effect before the implantation. Mutations in some genes could lead to epilepsy. Here we report two cases of pediatric patients with drug-resistant epilepsy treated by VNS therapy: Patient 1 with ARX mutation achieved good outcomes; Patient 2 with the CDKL5 mutation did not show improvement. Additionally, the therapeutic impact of VNS on brain networks was investigated, hoping to provide some empirical evidence for a better understanding of the mechanism of VNS treatment.

scholarly journals Sign and magnitude scaling properties of heart rate fluctuations following vagus nerve stimulation in a patient with drug-resistant epilepsy

2018 ◽  
Vol 10 ◽  
pp. 78-81 ◽  
Author(s):  
Eduardo Gutiérrez-Maldonado ◽  
Claudia Ivette Ledesma-Ramírez ◽  
Adriana Cristina Pliego-Carrillo ◽  
José Javier Reyes-Lagos
Keyword(s):  
Heart Rate ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Drug Resistant ◽  
Scaling Properties ◽  
Magnitude Scaling ◽  
Heart Rate Fluctuations ◽  
Drug Resistant Epilepsy

scholarly journals Expected Budget Impact and Health Outcomes of Expanded Use of Vagus Nerve Stimulation Therapy for Drug-Resistant Epilepsy

2018 ◽  
Vol 35 (10) ◽  
pp. 1686-1696 ◽  
Author(s):  
Molly F. Purser ◽  
Deirdre M. Mladsi ◽  
Alan Beckman ◽  
Francesca Barion ◽  
John Forsey
Keyword(s):  
Health Outcomes ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Budget Impact ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy
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