Studies show that VNS can offer improvements in behaviour for some epilepsy patients.
Hyderabad: Up to 70 per cent of people with epilepsy experience good control of their condition through medical management. For the remaining 30 per cent of patients, who continue to have frequent seizures despite taking multiple anti-seizure medications, treatment options can be limited.
On the eve of International Epilepsy Day, observed on the second Monday of February to bring focus on the brain disorder that causes seizures, doctors said one promising solution for these patients is vagus nerve stimulation (VNS), a technique that can help reduce the frequency and severity of seizures, significantly improving the quality of life for those with severe, drug-resistant epilepsy.
According to Dr Sita Jayalakshmi, consultant senior neurologist and epilepsy specialist, VNS is an important therapeutic option for patients whose epilepsy remains uncontrolled despite trying various anti-seizure medications.
“If there is a clear-cut operable lesion in the brain, surgical resection might be a good option for getting freedom from seizures,” she said. “In cases where surgery is not suitable, or when patients continue to experience frequent seizures, VNS can offer a significant benefit.”
Vagus nerve stimulation involves the implantation of a small device under the skin in the chest, which is connected to the vagus nerve in the neck. The device sends regular electrical pulses to the vagus nerve, which in turn influences the epileptogenic network in the brain. This action can help modulate brain activity and reduce the occurrence of seizures.
The device, often referred to as a pulse generator, stimulates the vagus nerve with electrical impulses. The impulses are thought to help regulate the electrical activity in the brainstem, which in turn helps reduce the intensity and duration of seizures.
VNS is considered a palliative add-on therapy, meaning that patients continue to take their anti-epileptic medications, while the
VNS device works to enhance the effects of the medication and improve seizure control.
In addition to reducing the frequency and severity of seizures, studies have shown that VNS can offer significant improvements in cognition and behaviour for some epilepsy patients. These benefits play an important role in enhancing the overall quality of life for patients living with epilepsy, helping them regain a sense of normalcy and improve their ability to engage in daily activities.
Vagus nerve stimulation is especially effective for patients with refractory seizures, which are seizures that do not respond to at least two anti-epileptic drugs taken in adequate doses over the course of at least a year. According to Dr Sireesha Yareeda, additional professor of neurology at the Nizam’s Institute of Medical Sciences (Nims), this neuro-modulation technique helps patients who have seizures despite trying multiple treatments.
“For patients suffering from drop attacks (sudden falls due to seizures), especially those who have sustained birth injuries, VNS can be a particularly beneficial option when other therapies have failed,” she said.
While VNS can offer great relief, it is important to note that it does not cure epilepsy. The device helps manage seizures but does not completely eliminate them. Patients will still need to continue with their prescribed medications and follow regular medical check-ups.
