<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Epilepsy affects approximately 50 million of people worldwide and 30% of them are resistant to drugs. Neuromodulation is becoming a key option in patients with drug-resistant epilepsy who are not feasible for resective surgery. Vagus nerve stimulation (VNS) is the most commonly used adjunctive neuromodulatory method in every patient aged 4 years and older who is unsuitable for resective surgery. It is a minimally invasive, non-teratogenic, extracranial pacemaker-like device which delivers electrical stimuli to the vagus nerve and desynchronize aberrant cerebral rhythms involved in epileptogenesis. In this review we approached the information and clinical data of VNS development history, clinical applications and possible mechanism of action. We will also review optimal stimulation parameters and information about closed and open loop devices. Vagus nerve stimulation is safe, efficient with no significant side effects and substantial cost-saving benefit, that also shows an important improvement in mood, behavior, cognition and quality of life. The overall responder rate was observed in more than 50% of patients. On the other hand, it is not clear which patients will respond to this method of treatment and why the response is not immediate, there are no available biomarkers or other features like age, sex, seizure type/epileptic syndrome to predict response to vagus nerve stimulation therapy. The VNS Therapy System continues to be an important prospect in the treatment of pharmacoresistant epilepsy, that requires further studies in order to ensure the most advantageous therapeutic response.</p>
</abstract>

Epilepsy affects approximately 50 million of people worldwide and 30% of them are resistant to drugs. Neuromodulation is becoming a key option in patients with drug-resistant epilepsy who are not feasible for resective surgery. Vagus nerve stimulation (VNS) is the most commonly used adjunctive neuromodulatory method in every patient aged 4 years and older who is unsuitable for resective surgery. It is a minimally invasive, non-teratogenic, extracranial pacemaker-like device which delivers electrical stimuli to the vagus nerve and desynchronize aberrant cerebral rhythms involved in epileptogenesis. In this review we approached the information and clinical data of VNS development history, clinical applications and possible mechanism of action. We will also review optimal stimulation parameters and information about closed and open loop devices. Vagus nerve stimulation is safe, efficient with no significant side effects and substantial cost-saving benefit, that also shows an important improvement in mood, behavior, cognition and quality of life. The overall responder rate was observed in more than 50% of patients. On the other hand, it is not clear which patients will respond to this method of treatment and why the response is not immediate, there are no available biomarkers or other features like age, sex, seizure type/epileptic syndrome to predict response to vagus nerve stimulation therapy. The VNS Therapy System continues to be an important prospect in the treatment of pharmacoresistant epilepsy, that requires further studies in order to ensure the most advantageous therapeutic response.

Vagus Nerve Stimulation (VNS) Therapy System in pharmacoresistant epilepsy: A literature review

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution 4.0 International License.

Epilepsy affects approximately 50 million of people worldwide and 30% of them are resistant to drugs. Neuromodulation is becoming a key option in patients with...

Vagus Nerve Stimulation (VNS) Therapy System in pharmacoresistant epilepsy: A literature review

Published Online: Sep 28, 2023

Page range: 157 - 162

Received: May 01, 2023

Accepted: Jun 28, 2023

DOI: https://doi.org/10.2478/amma-2023-0027

Keywords
vagus nerve stimulation, epilepsy, refractory, neuromodulation

© 2023 Valentin Moroșanu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Vagus Nerve Stimulation (VNS) Therapy System in pharmacoresistant epilepsy: A literature review

Published Online: Sep 28, 2023

Page range: 157 - 162

Received: May 01, 2023

Accepted: Jun 28, 2023

DOI: https://doi.org/10.2478/amma-2023-0027

Keywordsvagus nerve stimulation, epilepsy, refractory, neuromodulation

© 2023 Valentin Moroșanu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
vagus nerve stimulation, epilepsy, refractory, neuromodulation