Vagus Nerve Stimulation (VNS) involves periodic mild electrical stimulation of the vagus nerve in the neck by a surgically implanted device similar to a heart pacemaker.
VNS has been found effective in controlling some epilepsies when anti-epileptic drugs have been inadequate, their side effects intolerable, or neurosurgery has not been an option. In some cases, VNS has also been effective in stopping seizures.
Common side effects, which occur only during stimulation, may include a tingling sensation in the neck and/or mild hoarseness of the voice. Other possible side-effects may include coughing, voice alteration, shortness or breath, transient sensations of choking, throat pain, ear or tooth pain, and skin irritation or infection at the implant site. Unlike many medications, there seems to be no significant intellectual, cognitive, behavioural or emotional side effects to VNS therapy.
VNS is approved for use in Canada as an adjunctive therapy for some people with epilepsy. VNS is currently approved in more than 20 countries.
Recent reports (November 2000) state that VNS is now the second most common treatment for epilepsy in the United States of America. According to the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology, "the degree of improvement in seizure control from VNS remains comparable to that of new AEDs".
In Ontario, OHIP will cover the cost of the surgical procedure but not the cost of the implant for residents of Ontario. However, hospitals are beginning to include this in their budgets on a very limited basis. Consult your neurologist for more information.
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