Vagus Nerve Stimulation

Overview of Vagus Nerve Stimulation in India

Vagus nerve stimulation involves using a device to send electrical impulses to the vagus nerve. The vagus nerve is the main nerve of the system that controls digestion, heart rate and other vital functions. When the device fires, it sends electrical impulses to areas of the brain. This changes brain activity to treat certain conditions.

Devices for vagus nerve stimulation include one the Food and Drug Administration (FDA) approved that goes into the body, to treat epilepsy and depression. It works by sending impulses to areas of the brain that cause seizures and affect mood.

The FDA has approved another vagus nerve stimulation device for use after a stroke. For people who have trouble using their hand or arm after a stroke, the device helps make new pathways in the brain during exercise. This can help people regain the use of the affected hand or arm.

What Is Vagus Nerve Stimulation?

Vagus Nerve Stimulation (VNS) is a neuromodulatory therapy, which refers to the use of a device to modify the activity of the vagus nerve. The device is implanted under the skin and provides small electrical pulses to the vagus nerve in your neck, which then travels to the brainstem, where they are distributed across various regions of your brain to alter cellular activity.

VNS works in a similar manner to a cardiac pacemaker, which has also been referred to as “the brain's pacemaker.”

VNS is an option for you and your healthcare provider to consider after you haven't had success with other therapies. Patients who qualify for VNS include those with intractable epilepsy or intractable depression. Recently, VNS has also been approved as an adjunct therapy for certain stroke patients.

Types of Vagus Nerve Stimulation:

Procedure:

Before the procedure

You receive a physical examination before to surgery. To prevent infection, your surgeon might advise you to begin taking antibiotics prior to surgery. 

During the procedure

Usually when you get this operation done, the surgery will only require one visit to the hospital, which would allow you to go home right after. You will receive medicine to calm you down, and depending on how much sleeping medicine they have given you, you may not remember much about when you wake up.

The patient's brain does not get operated on at all. The surgeon will make two cuts (or incisions). The first cut will either be on the chest or in the area of the armpit, and the second cut will be on the left side of the neck.

A pulse generator is inserted into the upper left chest and is approximately the size of a stopwatch. The pulse generator is powered by batteries.

A lead wire connects to the pulse generator that is guided under the skin from the chest to the neck by the surgeon when he/she cuts the second incision. After that, the lead wire is inserted through the second incision into the left vagus nerve.

The device has a battery that will last for years, and there will also be a procedure to remove the device if necessary.

After the procedure

If you had the device implanted to treat epilepsy or depression, your healthcare team usually turns on the pulse generator during a medical visit a few weeks after surgery, not immediately. Then the team figures out the timing and how often the device sends electrical impulses to the vagus nerve, like a sort of schedule.

Vagus nerve stimulation often starts pretty low. Your healthcare team can raise the settings later, depending on how your symptoms are going and what side effects you get.

The device works in cycles—something like 30 seconds on, then five minutes off. During the on part you might notice tingling or a mild ache in your neck. Also, your voice can sound hoarse when the device is active.

Newer models that treat epilepsy can detect a sudden rise in heart rate and respond by sending a signal to the nerve. A sudden increase in heart rate might mean a seizure is coming. You can also use a hand-held magnet to trigger the impulse at other times. For example, you may flip it on when you feel you’re about to have a seizure, before it fully starts.

For a device placed after a stroke, a specialist typically switches it on during rehabilitation. You can even turn it on at home with a magnet, if you’re instructed to. Some people use it to support certain routines, like cooking or other practical tasks.

You’ll still need follow-up appointments with your healthcare professional, to confirm the pulse generator is working properly and hasn’t shifted out of place. And check with your healthcare team before you get medical tests, such as an MRI. That test could interfere with the device, so it matters.