Epilepsy is a serious neurological
disorder that affects approximately 1% of the U.S. population,
including 30,000 people on Long Island. Approximately 80% of
people living with epilepsy are able to control their seizures
with anti-epilepsy medications. However, the remaining 20% of
people with epilepsy are refractory, meaning they do not achieve
satisfactory seizure control with medications. A person with
uncontrolled seizures often cannot hold a job, attend school,
drive or do many of the activities most of us take for granted.
A new treatment modality for epilepsy
now offers an alternative option to refractory patients. Vagus
Nerve Stimulation (VNS) is a unique approach to treating epilepsy
and has been approved by the U.S. Food and Drug Administration
as an effective, safe therapy for reducing the frequency and
severity of seizures in adults and adolescents over the age of
twelve with refractory epilepsy.
The vagus nerve stimulatory consists
of a pacemaker-like generatory that is implanted in the chest
during a simple one to two hour surgical procedure. Wires are
tunneled under the skin from the generator to the left vagus
nerve in the neck. Electrodes wrapped around the vagus nerve
deliver regular electrical stimulation 24 hours per day, which
are programmed by the physician using an external programming
wand. The frequency and intensity of the stimulation can be adjusted
to optimize seizure control. In addition to the regular stimulation
programmed by the physician, if patients sense a seizure coming
on they can pass a special magnet over the area in the chest
where the deviceis implanted, triggering an additional dose of
stimulation to abort or decrease the severity of the seizure.
VNS has many advantages over anti-epileptic
medications. Medications often have numerous and severe side
effects ranging from weight gain, fatigue, and ataxia to cognitive
impairment. The most common side effects reported with VNS are
a tickling in the throat and a change in the voice while the
device is actually stimulating the nerve. In addition, the magnet
that allows patients to activate the stimulator themselves provides
many patients with a sense of being in control of their seizures
for the first time ever. It is important to note that VNS has
no interaction with medications.
Many of the over 4,500 patients
worldwide who have been treated with this novel approach to seizure
control have found that VNS is an effective way of controlling
seizures, and does not have the negative side effects associated
with anti-epileptic medications. Practices such as South Shore
Neurologic Associates and community hospitals like Brookhaven
Memorial Hospital are pioneering the use of this device to bring
this treatment option to the 30,000 people on Long Island who
might benefit from its use. For additional information on vagus
nerve stimulation (VNS) contact Cyberonics (www.cyberonics.com
1-800-332-1375) or South Shore Neurologic Associates 631-666-3939
(office locations).
What
is VNS?
VNS
Indications
VNS
Device
Operation
Programmer
Treatment
Results
Side
Effects
Magnets
Cost
& Insurance Coverage
The information contained
in the web site was obtained courtesy of Cyberonics, from current
published literature, and other web sites.
Mark Gudesblatt, M.D.
South Shore Neurologic
Associates, Bay Shore, New York
