Surgical Treatment for Epilepsy and Seizure Management
Loyola Medicine offers vagus nerve stimulation (VNS) as an alternative treatment for epilepsy when medication management is not effective in controlling seizures. Your neurologist first will try a conservative approach to control your seizures by prescribing the latest anticonvulsant medications. However, if this doesn’t provide relief, your doctor may suggest VNS to reduce the frequency or severity of your seizures.
There are two vagus nerves, which run along each side of the body from the brainstem through the neck to the abdomen. These nerves, which are part of the autonomic nervous system, control involuntary functions of the body, such as breathing and heart rate.
Similar to a pacemaker, the implanted VNS device is programmed to deliver small and regular electrical impulses to this nerve. This therapy has proven beneficial in decreasing the frequency and severity of seizures for many patients.
Loyola’s neurosurgeons are highly experienced in this treatment, and our neurologists are skilled in determining the best signal pattern for your type of seizures. In addition, Loyola is designated as a level 4 epilepsy center by the National Association of Epilepsy Centers (NAEC), meaning it offers the highest level of specialized epilepsy care available for adults and children as young as 2 years of age.
Why Choose Loyola for Vagus Nerve Stimulation?
Loyola’s compassionate team understands that epilepsy can be life-changing not only for the patient, but also for family members. Loyola's neurology and neurosurgery departments are ranked 37th in the country on U.S. News & World Report's 2018-2019 Best Hospitals list.
Further, our epilepsy center is an NAEC-designated (National Association of Epilepsy Centers) level 4 epilepsy center, offering pediatric and adult epileptologist consultation and using state-of-the-art neuroimaging and electrodiagnostic technology to identify and assess complex seizure disorders by short and long-term monitoring. Our center is staffed by epileptologists who have completed a specialized epilepsy fellowship or are board-certified neurologists with secondary board certification in clinical neurophysiology.
If a seizure results in a stay in Loyola’s neuro intensive care unit, you will receive the highest quality patient care. The unit is equipped with continuous EEG and video monitoring for adults and children and is staffed by certified technologists and trained neurology nurses who have earned Magnet status.
What to Expect
What to Expect with Vagus Nerve Stimulation (VNS)
At Loyola, vagus nerve stimulation may be performed in an outpatient setting or may require an overnight stay. Your surgery will take one to two hours to complete, and is performed with either local or general anesthesia. During VNS, your neurosurgeon will make two small incisions, one in your neck and another in your chest. The stimulator, which is about the size of a stopwatch, is implanted in the left side of your chest.
Your Loyola neurosurgeon will thread a wire, or lead, from the device to the left side of your neck and then work through the second incision to connect the lead to the left vagus nerve. Once you recover, you will be given instructions on how to use a hand-held magnetic device that can deliver immediate electric impulses if you feel the aura of an impending seizure.
What are the Risks of Vagus Nerve Stimulation?
Vagus nerve stimulation is considered a low-risk surgery, however as with any surgery there are risks. You may experience:
- Pain at the incision site
- Problems swallowing
- Surgical scar discoloration
- Vocal cord paralysis (which is usually temporary)
While using the implanted device, you may experience:
- Abdominal pain
- Chest pain
- Hoarse voice (dysphonia)
- Swallowing problems (dysphagia)
- Throat pain
- Tingling (paresthesia)
- Trouble breathing (dyspnea)
- Voice changes