Vagus-nerve stimulation for the treatment of epilepsy

Ben-Menachem, Elinor

doi:10.1016/s1474-4422(02)00220-x

Cited by 560Vagus Nerve Stimulation ResearchEpilepsy research and treatmentNeurological disorders and treatments

Vagus-nerve stimulation for the treatment of epilepsy

Ben-Menachem, Elinor·2002·The Lancet Neurology

DOI 10.1016/s1474-4422(02)00220-x

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Abstract

Vagus-nerve stimulation (VNS) is now an accepted treatment for patients with refractory epilepsy. There have been many studies suggesting that VNS affects the brain in such areas as the thalamus and other limbic structures. In addition, there is some evidence that norepinephrine is important in the prophylactic antiseizure effects of VNS. The efficacy of VNS has been established for partial seizure types, even in refractory patients who did not respond to surgical treatment for epilepsy. There are also data, from open-label studies, that suggest efficacy in other seizure types. Therefore, VNS seems to be a broad-spectrum treatment for epilepsy. Improvement is not immediate but increases over 18-24 months of treatment. Most studies report subjective improvements in various quality-of-life measurements during treatment with VNS--objective trials have confirmed this observation. Side-effects are mainly stimulation related and reversible and they tend to decrease over time. They are generally mild to moderate and seldom necessitate the removal of the device. No idiosyncratic side-effects have been reported in 12 years of experience, and VNS does not interact with antiepileptic drugs. Most adverse events are predictable and related to the specific stimulation regimen. VNS does not have cognitive and systemic side-effects and can, therefore, be a valuable treatment approach even for patients who have poor tolerance of antiepileptic drugs.

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Appropriate electrical stimulation can elicit a targeted muscular response in nerve palsies, as in functional electrical stimulation for foot drop, bladder control in paraplegia, and vagal nerve stimulation for epilepsy.
“For example, in the case of nerve palsies appropriate electrical stimulation can be used to elicit a targeted muscular response, such as the use of functional electrical stimulation (FES) in foot drop (Lyons etal. 2002), bladder control in paraplegia (Brindley 1994; Brindley etal. 1982), or treatment of epilepsy by vagal nerve stimulation (Ben-Menachem 2002).”
From Peripheral nerve bionic interface: a review of electrodes (2019) · cites this paper as Ben-Menachem 2002

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Authors: Ben-Menachem, E.
Venue: The Lancet Neurology
Publisher: Elsevier BV
Published: 2002-12
Volume: 1
Issue: 8
Pages: 477-482
ISSN: 1474-4422 (ISSN-L)
DOI: 10.1016/s1474-4422(02)00220-x
OpenAlex: W1971482087
Cited by: 560
References: 60
Citations by year: 2026: 28 · 2025: 34 · 2024: 36 · 2023: 39 · 2022: 42 · 2021: 30 · 2020: 38 · 2019: 23 · 2018: 20 · 2017: 19 · 2016: 24 · 2015: 34 · 2014: 22 · 2013: 23 · 2012: 30
FWCI: 0.81
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet Neurology (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
Health Sciences › Medicine › Neurology › Neurological disorders and treatments
Keywords: vagus nerve stimulation, drug-resistant epilepsy, norepinephrine, focal seizures, thalamus, limbic structures, quality of life, adverse effects, seizure types
MeSH terms: Adolescent, Animals, Child, Child, Preschool, Clinical Trials as Topic, Electrodes, Implanted, Electric Stimulation Therapy, Epilepsy, Humans, Quality of Life, Vagus Nerve

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Vagus-nerve stimulation for the treatment of epilepsy

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