Externalization of an infected Vagus Nerve Stimulator generator without a break in anti- seizure therapy: A technical note

Abstract

Vagus Nerve Stimulation (VNS) is a widely used treatment for drug-resistant epilepsy. An infection of the VNS generator pocket occurs in 3–8% of cases. Current standard of care requires the removal of the device, antibiotic therapy and then replacement of the device. The consequential break in VNS therapy leaves patients highly susceptible to seizures. Here, we report novel management of an infected VNS generator with externalization and short interval replacement of the entire system without any break in anti-seizure therapy. The patient is now seven months post-operative and without any evidence of infection.