About epilepsy: vagus nerve stimulation (vns)

What is epilepsy: vagus nerve stimulation (vns)?

Vagus nerve stimulation (VNS) is a technique used to treat epilepsy. It involves implanting a pacemaker-like device that generates pulses of electricity to stimulate the vagus nerve. The vagus nerve is one of the 12 cranial nerves, the paired nerves that attach to the undersurface of the brain and relay information to and from the brain. Cranial nerve fibers conduct impulses between the brain and other parts of the brain and various body structures, mostly in the head and neck. The vagus nerve - the longest of the cranial nerves - also extends to organs in the chest and abdomen. (The word vagus comes from a Latin word for "wandering.')

Some cranial nerves bring information from the senses (like touch or sight) to the brain (sensory) and some control muscles (motor). Other cranial nerves, like the vagus, have both motor and sensory functions. The vagus nerve serves many organs and structures, including the larynx (voice box), lungs, heart and gastrointestinal tract.

How Is Vagus Nerve Stimulation Done?

While the patient is asleep (general anesthesia), the stimulator device - which is about the size of a silver dollar - is surgically placed under the skin in the upper part of the chest. A connecting wire is run under the skin from the stimulator to an electrode that is attached to the vagus nerve, which is accessible through a small incision (cut) in the neck.

After it is implanted, the stimulator is programmed using a computer to generate pulses of electricity at regular intervals, depending on the patient's tolerance. For example, the device may be programmed to stimulate the nerve for 30 seconds every five minutes. The settings on the device are adjustable, and the electrical current is gradually increased as the patient's tolerance increases. Re-programming the stimulator can be done in the doctor's office. The patient also is given a hand-held magnet, which when brought near the stimulator, can generate an immediate current of electricity to stop a seizure in progress or reduce the severity of the seizure.

VNS is an add-on therapy, which means it is used in addition to another type of treatment. Patients who undergo VNS continue to take their seizure medications. In some cases, however, it may be possible to reduce the dosage of medication.

When Is VNS Used?

Brain cells communicate by sending electrical signals in an orderly pattern. In people with epilepsy, this pattern is sometimes disrupted due either to an injury or the person's genetic make-up, causing brain cells to emit signals in an uncontrolled fashion. This creates over-excitement, somewhat like an electrical overload in the brain, leading to seizures. Seizures can be produced by electrical impulses from throughout the brain, called generalized seizures, or from a small area of the brain, called partial seizures.

Most people with epilepsy can control their seizures with medications called anti-convulsant or anti-seizure drugs. About 20% of people with epilepsy do not respond to anti-seizure medications. In some cases, surgery to remove the part of the brain causing the seizures may be used. VNS may be a treatment option for people whose seizures are not controlled by anti-seizure medications and who are not considered good candidates for surgery; for example, if their seizures are produced throughout the brain (generalized).

How Does VNS Work?

It is not known exactly how VNS works. It is known, however, that the vagus nerve is an important pathway to the brain. It is thought that by stimulating the vagus nerve, electrical energy is discharged upward into a wide area of the brain, disrupting the abnormal brain activity responsible for seizures. Another theory suggests that stimulating the vagus nerve causes the release of special brain chemicals that decrease seizure activity.

What Are the Risks of VNS?

The risks of VNS include injury to the vagus nerve or nearby blood vessels, including the carotid artery and jugular vein. In addition, there are risks associated with any surgical procedure, such as infection, bleeding and an allergic reaction to the anesthesia.

What Are the Benefits of VNS?

VNS is not a cure, and the total elimination of seizures is rare. However, many people who undergo VNS experience a significant (more than 50%) reduction in the frequency of seizures, as well as a decrease in seizure severity. This can greatly improve the quality of life for people with epilepsy.

What are the treatments for epilepsy: vagus nerve stimulation (vns)?

Medication is usually the first line of treatment for vagus nerve stimulation (VNS). In the event that drugs are ineffective, doctors could recommend surgery or another form of treatment.

1. Medication
The majority of epileptics can go epilepsy-free by using one anti-seizure medicine, commonly known as an anti-epileptic drug. A combination of drugs may help some people reduce the frequency and severity of their seizures.

Many kids with epilepsy who aren't exhibiting any symptoms will eventually be able to stop taking their medications and lead seizure-free lives. After two or more years without seizures, many adults are able to stop taking their drugs. When to discontinue taking your prescriptions will be determined by your doctor

2. Surgery
Surgery might be a possibility if medication-only treatment for seizures is ineffective. In epilepsy surgery, the part of your brain causing seizures is removed.

Surgery is generally performed by doctors when tests reveal:

Your brain's small, clearly-defined area where seizures begin is where they begin.

Surgery won't affect any of your brain's essential processes, including speech, language, motor coordination, vision, or hearing.

3. MRI
When an open operation may be too hazardous for some types of epilepsy, minimally invasive techniques like MRI-guided stereotactic laser ablation may offer effective treatment. In these procedures, a thermal laser probe is pointed toward the exact region of the brain causing seizures in an effort to eliminate that tissue and better regulate the seizures

4. Vagus nerve stimulation

In order to stimulate the vagus nerve, doctors insert a tool called a vagus nerve stimulator beneath your chest skin, much like a heart pacemaker. The vagus nerve in the neck is connected by wires from the stimulator.

Although some people may be able to reduce their prescription dose, the majority of individuals must still take anti-epileptic medicine. Vagus nerve stimulation can have negative side effects, including coughing, hoarseness, throat soreness, and shortness of breath.

Temporary perplexity,Gazing constantly,Rigid muscles,Jerky, uncontrollable arm and leg movements,Loss of awareness or consciousness,Psychological signs like worry, terror, or déjà vu
Falling,Drowning,Pregnancy complications,Emotional health issues
Anti-epileptic drug

What are the symptoms for epilepsy: vagus nerve stimulation (vns)?

Employing a device to deliver electrical impulses to the vagus nerve is known as vagus nerve stimulation (VNS). The application of an implantable vagus stimulator to treat epilepsy is officially approved by the FDA. Each side of your body has one vagus nerve, which travels from your brainstem through your neck to your chest and belly.

A neurological condition called epilepsy affects the brain and increases the risk of recurring, unprovoked Seizures in affected individuals. People of various ages, races, and ethnic backgrounds are affected by this disorder of the neurological system, which is one of the most prevalent.

Symptoms of epilepsy

The symptoms will be consistent from episode to episode since, in the majority of situations, a person with epilepsy tends to experience the same sort of seizure every time. According to how and where the aberrant brain activity starts, doctors typically categorize Seizures as either focal or generalized. Seizures can disrupt any brain-coordinated process since epilepsy is brought on by aberrant brain activity. Some seizure warning signs and symptoms include:

1. Temporary perplexity
2. Gazing constantly
3. Rigid muscles
4. Jerky, uncontrollable arm and leg movements
5. Loss of awareness or consciousness
6. Psychological signs like worry, terror, or déjà vu

Focal epilepsy symptoms might be mistaken for those of other neurological conditions such migraine, narcolepsy, or mental illness. To identify epilepsy from other illnesses, a thorough examination and tests are required.

The Diagnosis of epilepsy

Immediately following the onset of symptoms, the full degree of epilepsy might not be fully appreciated, but a thorough medical evaluation and diagnostic tests may disclose it. Physical examinations and diagnostic testing are used to determine whether someone is having a seizure. The doctor questions the child and family for a detailed medical history during the examination and inquires as to the timing of the seizures. Seizures may be caused by neurological issues and call for additional medical attention.

Temporary perplexity,Gazing constantly,Rigid muscles,Jerky, uncontrollable arm and leg movements,Loss of awareness or consciousness,Psychological signs like worry, terror, or déjà vu
Falling,Drowning,Pregnancy complications,Emotional health issues

Anti-epileptic drug

What are the causes for epilepsy: vagus nerve stimulation (vns)?

About half of those who suffer from epilepsy have no known cause. The condition vagus nerve stimulation (VNS) in the other half can be attributed to a number of factors, such as:

1. A genetic component: Some forms of epilepsy run in families and are classified by the sort of seizure you have or the area of the brain that is affected. There most likely is a genetic component in these circumstances. Researchers have connected various forms of epilepsy to particular genes, but for the majority of people, genes account for only a portion of the disease's causes. A person's susceptibility to seizure-inducing environmental factors may be increased by specific genes.

2. Head injury: Epilepsy may arise after head trauma from a vehicle accident or another traumatic injury.

3. Abnormalities in the brain: Epilepsy can be caused by abnormalities in the brain, such as brain tumors or vascular anomalies, including arteriovenous malformations (AVMs) and cavernous malformations. Stroke is the main contributor of epilepsy in people over 35.

4. Infections: Meningitis, HIV, viral encephalitis, and a number of parasitic diseases can all result in epilepsy.

5. Birth damage: Babies are vulnerable to brain injury before birth, which can be brought on by a number of things, including a mother's infection, inadequate nourishment, or oxygen deprivation. This brain injury may lead to epilepsy or cerebral palsy.

6. Development disorders or defects can be detected: Epilepsy and developmental disorders like autism sometimes coexist.

Temporary perplexity,Gazing constantly,Rigid muscles,Jerky, uncontrollable arm and leg movements,Loss of awareness or consciousness,Psychological signs like worry, terror, or déjà vu
Falling,Drowning,Pregnancy complications,Emotional health issues
Anti-epileptic drug

What are the risk factors for epilepsy: vagus nerve stimulation (vns)?

The risk of vagus nerve stimulation (VNS) may be impacted by the following factors:

1. Age: Although epilepsy can develop at any age, it most frequently does so in children and older individuals.

2. Family history: You may be more likely to develop a seizure problem if you have a family history of epilepsy.

3. Head trauma: Some cases of epilepsy are caused by head injuries. Wearing a seatbelt in a car and a helmet while biking, skiing, riding a motorbike, or taking part in other sports that carry a high risk of head injuries will lower your risk.

4. Stroke and other vascular conditions: Damage to the brain from a stroke or other vascular (blood vessel) condition may result in epilepsy. Several actions can be taken to lower your chance of developing these illnesses, such as limiting your alcohol intake, quitting smoking, maintaining a healthy diet, and engaging in regular exercise.

5. Dementia: In elderly persons, dementia can raise the risk of epilepsy.

6. Having brain infection: Your risk can be raised by illnesses like meningitis, which can result in inflammation of the brain or spinal cord.

7. Emotional health issues: Psychological issues, including depression, anxiety, and suicidal thoughts and actions, are more prevalent in people with epilepsy. Even people with well-controlled epilepsy are more prone to complications because of both the condition itself and the treatment side effects.

For most epilepsy patients, treatment with drugs or occasionally surgery can control seizures. While some people need ongoing medication to manage their seizures, others finally experience a cessation of their seizures. With time, some epileptic children may outgrow their affliction.

Temporary perplexity,Gazing constantly,Rigid muscles,Jerky, uncontrollable arm and leg movements,Loss of awareness or consciousness,Psychological signs like worry, terror, or déjà vu
Falling,Drowning,Pregnancy complications,Emotional health issues
Anti-epileptic drug

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