Vagal Nerve Stimulation

Abstract

BACKGROUND:The vagus nerve stimulation (VNS) is an approach mainly used in cases of intractable epilepsy despite all the efforts. Also, its benefits have been shown in severe cases of depression resistant to typical treatment.AIM:The aim of this study was to present current knowledge of vagus nerve stimulation.MATERIAL AND METHODS:A new value has emerged just at this stage: VNS aiming the ideal treatment with new hopes. It is based on the placement of a programmable generator on the chest wall. Electric signals from the generator are transmitted to the left vagus nerve through the connection cable. Control on the cerebral bioelectrical activity can be achieved by way of these signal sent from there in an effort for controlling the epileptic discharges.RESULTS:The rate of satisfactory and permanent treatment in epilepsy with monotherapy is around 50%. This rate will increase by one-quarters (25%) with polytherapy. However, there is a patient group roughly constituting one-thirds of this population, and this group remains unresponsive or refractory to all the therapies and combined regimes. The more the number of drugs used, the more chaos and side effects are observed. The anti-epileptic drugs (AEDs) used will have side effects on both the brain and the systemic organs. Cerebral resection surgery can be required in some patients. The most commonly encountered epilepsy type is the partial one, and the possibility of benefiting from invasive procedures is limited in most patients of this type. Selective amygdala-hippocampus surgery is a rising value in complex partial seizures. Therefore, as epilepsy surgery can be performed in very limited numbers and rather developed centres, success can also be achieved in limited numbers of patients. The common ground for all the surgical procedures is the target of preservation of memory, learning, speaking, temper and executive functions as well as obtaining a good control on seizures. However, the action mechanism of VNS is still not exactly known. On the other hand, it appears to be a reliable method that is tolerated well in partial resistant seizures. It has been observed that adverse effects are generally of mild-medium severity, and most of the problems can be eliminated easily through the re-adjustment of the stimulator.CONCLUSION:VNS, which is a treatment modality that will take place it deserves in epilepsy treatment with “the correct patient” and “correct reason”, must be known better and its applications must be developed.

Activation of the Cholinergic Anti-Inflammatory Pathway as a Novel Therapeutic Strategy for COVID-19

“…Most of the cases will encounter no problems. Perioperative complications of VNS are mostly related with cardiac dysrhythmias, which could be adjusted by elongating the off period ( 101 ). For severe COVID-19 patients, careful evaluation and monitoring in cardiovascular system are still necessary.…”

MicroCT optimisation for imaging fascicular anatomy in peripheral nerves

“…This is undertaken by electrical stimulation of autonomic nerves (Famm et al, 2013;Kollewe, 2017;Mishra, 2017). A prime target for intervention is the cervical vagus nerve (Blount, 2015;Ekmekçi and Kaptan, 2017;Guiraud et al, 2016;Koopman et al, 2016;Pečlin and Rozman, 2014;Smucny et al, 2015), as it innervates the majority of the visceral organs and muscles (Câmara and Griessenauer, 2015;Rea, 2014). However, surprisingly, the organisation of fascicles within the nerve remains almost completely unknown.…”

Sepsis: developing new alternatives to reduce neuroinflammation and attenuate brain injury

“…Different parameters should be applied to stimulate anti‐inflammatory efferent fibers. The most frequent acute complications of EVNS implantation include temporary excessive salivation, mild and coercive cough, vocal cord paralysis, lower facial weakness, and, very rarely, bradycardia asystole, all of which are reversible . In the long‐term patients, cough, chest pain, thickening of the voice, and feeling of compression of the chest have been observed; these symptoms usually decrease over time, and the device will not have cognitive or systemic effects.…”