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 OPERATIVE NUANCES STEP BY STEP (VIDEO SECTION)
Year : 2020  |  Volume : 68  |  Issue : 8  |  Page : 325--327

Vagal Nerve Stimulation for Drug Refractory Epilepsy


1 Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
2 Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Prof. Poodipedi Sarat Chandra
Department of Neurosurgery, PI and Team leader COE and MEG Centre, Core Faculty Incharge Epilepsy Functional Neurosurgery, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.302458

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Background: Vagal nerve stimulation (VNS) is a form of neuromodulation for patients with drug-refractory epilepsy (DRE), in whom extensive preoperative evaluation fails to localize the epileptogenic zone. VNS is often compared to Corpus callosotomy (CC) in terms of both indications and efficacy. However, VNS represents a less invasive and less morbid procedure compared to CC and is the preferred procedure in majority of patients with DRE. Objective: The aim of this study was to present the surgical technique and nuances involved in the implantation of vagal nerve stimulator. Procedure: A 16-year-old boy suffering from DRE, with bilateral seizure onset on evaluation, for 12 years, underwent left vagal nerve stimulator placement. The VNS device has a lead and a pulse generator, the lead has coils to be wrapped around the vagus nerve and the pulse generator is placed in a subcutaneous pocket in the infraclavicular region (demonstrated in the video). Results: The patient is relieved of the disabling drop attacks along with improved cognitive functions at 1 year follow up. Conclusions: In carefully selected patients, VNS is a safe and effective procedure to alleviate seizures, in cases otherwise morbidly affected due to drug refractory epilepsy.






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