Vagus nerve stimulation in epilepsy – literature review

Abstract

Introduction and Objective.Epilepsy is a brain disorder characterized by a predisposition to induce epileptic seizures. Neurostimulation is one of the therapeutic methods for drug-resistant epilepsy. The choice of therapeutic method is determined by the patient's condition and an assessment of the benefits and risks of possible side-effects during the use of a particular treatment method. The aim of this review is to provide information on vagus nerve stimulation (VNS) as a therapeutic method for epilepsy. Review methods. The review is based on scientific publications in PubMed, Google Scholar, and NCBI databases. The articles were published in English. After the initial evaluation of articles, meta-analyses, case series studies and reviews considering VNS were chosen. Brief description of the state of knowledge. VNS is usually considered as a palliative procedure for patients who have unsuccessfully used multiple antiepileptic drugs, and have contraindications to surgical resection of the epileptogenic focus. The device used to stimulate the vagus nerve consists of a pulse generator and a wire with electrodes that are wrapped around the left vagus nerve. About 45-65% of patients respond positively to VNS implantation. However, side-effects include post-operative infection, vocal cord paresis, cough and neck pain, among the others. In addition to VNS, neuromodulation techniques include deep brain stimulation (DBS) and responsive neurostimulation (RNS). Summary. The therapeutic process of epilepsy is a major challenge for doctors. The emergence of new therapeutic methods obliges doctors to update their knowledge of the available methods. The authors of the review emphasize the importance of VNS in the treatment of patients with epileptic seizures. When administered and used correctly, the VNS can be an effective therapeutic solution.