Vagal nerve stimulation is a treatment used to reduce the frequency and intensity of seizures when medications aren't effective.
The vagus nerve is one of many nerves that carry messages to and from the brain. It helps regulate internal organs such as the heart and stomach. Nerve fibers within the vagus nerve are connected to the part of the brain that we think is responsible for producing seizures.
This surgical procedure involves placing a small electric stimulator in the neck around the vagus nerve and a power source near the armpit or chest. The device works like a heart pacemaker to stimulate the left vagus nerve. It automatically sends intermittent electrical signals to the brain and can be manually activated to attempt to interrupt a seizure that's just starting.
At UCSF Benioff Children's Hospital, our neurologists and neurosurgeons are experts in implanting vagal nerve stimulators to treat seizures caused by diseases such as epilepsy.
Children who lose consciousness during complex partial seizures or generalized seizures, and whose seizures are not being controlled by medication, may benefit from vagal nerve stimulation.
This treatment can result in fewer or less severe seizures, although not all children see improvement. In all cases, children need to continue to take anti-epileptic medication as they did before the stimulator was inserted. In some cases, your neurologist may recommend that the use of medication be reduced a few months after vagal nerve stimulation has begun.
The procedure is performed on children as young as age 4. It is not used on children with severe asthma or severe heart disease, particularly those with an irregular heartbeat.
Before inserting a vagal nerve stimulator, our doctors and nurses will thoroughly evaluate your child's medical condition. They will ask you about your child's medical history as well as your immediate family's medical history. If your pediatrician has sent us your child's medical records, we will review this information. Be sure to tell your doctors about any medications your child is currently using, including over-the-counter medications, vitamins, nutritional supplements and herbal remedies.
Your neurologist will first confirm the diagnosis of epilepsy or other disorder-causing seizures. To make a diagnosis, your child may undergo imaging tests such as:
The vagal nerve stimulator is inserted during an operation that takes one to two hours. A cable is inserted to connect the stimulator with a nerve in the neck. The stimulator is programmed to stimulate the nerve at regular intervals. The battery in the stimulator will need to be replaced about every 10 years. This can be done during a simple procedure, which doesn't require a hospital stay, using local anesthesia.
Many patients experience some tingling in the neck or hoarseness during the stimulation pulses. Most patients get used to these feelings over time.
Your doctors will provide follow-up care to ensure that your child's vagal nerve stimulator is working properly and helping to control his or her seizures.
Reviewed by health care specialists at UCSF Benioff Children's Hospital.