If your child has intractable epilepsy, experts at the Children’s Health℠ nationally recognized Pediatric Epilepsy Center can help. As home to top pediatric epilepsy specialists, we regularly treat children who need help getting epilepsy seizures under control. And we are experts in using vagus nerve stimulation to reduce and manage seizures in children.
Pediatric vagus nerve stimulation is a treatment for children who have epilepsy, particularly children who have seizures that don’t respond to medication (also called intractable epilepsy).
The vagus nerve runs from the heart to the brain and helps control many internal organ functions, including breathing and heart rate.
To reduce epilepsy seizures with pediatric vagus nerve stimulation, we surgically place a small battery in the chest wall and connect it to electrodes wrapped around the left vagus nerve deep in the neck. The battery allows stimulation to be sent along the vagus nerve, signaling the brain to reduce seizures’ intensity, length and frequency. The device works by:
Pediatric vagus nerve stimulation is not a cure for pediatric epilepsy. However, when taken with the proper medication, many children will have fewer seizures. In our experience, about half of children treated with this approach experience up to 50% fewer seizures when evaluated 2 years after the implantation of the device. Those seizures may also be less severe, shorter and with a faster recovery time.
Additionally, vagus nerve stimulation offers peace of mind. Because you can manually activate the battery, you can step in as soon as your child starts seizing. The device also has built in safeguards to prevent overuse (overstimulation).
It can take some time before your child sees the full benefit of vagus nerve stimulation (although some children may experience a “honeymoon” period where it seems like seizures have disappeared immediately after placement).
With the addition of new medications, the seizures often can settle in the short term then recur. With VNS the seizures often slowly settle over time. Our team of brain specialists (neurologists) will work with your child to find the ideal combination of medication and device programming that works best for them.
Treatment results may include a:
Most of the side effects of the pediatric vagus nerve stimulation procedure are mild. Often these side effects are only present when the device is stimulating the nerve, and will become more tolerable with time.
Your child may experience no side effects, or they may experience:
Like all surgeries, pediatric vagus nerve stimulation has some risks, though they are uncommon. Our team will discuss the following risks with you and how we manage them, including:
The VNS generator has a battery life or up to 5-10 years before it will need to be changed. This will depend on the stimulation settings.
The procedure to place the pediatric vagus nerve stimulation device will take about an hour and a half (and add another 90 minutes for going to sleep and waking up before and after the procedure).
During the procedure, we will give your child medication to help prevent infection (antibiotics) and medication to help them stay asleep during the procedure (anesthesia).
Your child’s surgeon will make 2 small incisions (cuts) during the procedure, one near the left armpit and one on the left side of the neck. They will expose the vagus nerve, then loop the wires around this nerve and close the incision.
Next, they will attach the battery/generator to the wires that have been placed under the skin to the armpit incision and position the small battery device into the chest wall. All incisions will then be closed.
You and your child will stay with us overnight so that we can observe and monitor their health. After the procedure, most children feel a small bump under the skin near the device, while others don't feel the device at all.
A vagus nerve stimulator is a small device that sends electrical signals up the vagus nerve. It helps reduce the frequency and duration of seizures for people (both adults and children) with epilepsy that can’t be treated surgically or doesn’t respond to medication alone.
There may be some discomfort at the surgical site immediately after the procedure, but we will advise you on the best medication and treatment to help keep your child comfortable.
Vagus nerve stimulation is a procedure to help control seizures in children with epilepsy that hasn’t responded to lifestyle changes, different medications or that is unable to be treated surgically.