Vagus Nerve Stimulation for Epilepsy & Seizure Disorders in Children

In vagus nerve stimulation, surgeons at Hassenfeld Children’s Hospital at NYU Langone use the vagus nerve to send signals to the brain to stop the electrical activity that causes seizures in children with epilepsy and seizure disorders. The vagus nerve travels from the brainstem, down the neck, and into the chest and abdomen. It influences the activity of many organs.

Experts at the Comprehensive Epilepsy Center have performed about 1,700 vagus nerve stimulation procedures and are leaders in providing this treatment to children with epilepsy.

For this procedure, our experts implant a stimulating device the size of a silver dollar under the skin of the upper chest. A connecting wire runs under the skin from the stimulator to an electrode that is attached to the vagus nerve, which is accessible through a small incision in the neck.

After the stimulating device is implanted, a doctor programs it to deliver small electrical signals to the vagus nerve and into the brain at periodic intervals, usually for 30 seconds every 5 minutes. During follow-up visits, the doctor adjusts the settings, taking into account the child’s tolerance and seizure response.

A person with a stimulating device has some control over it. Each child receives a magnet that can activate the device. When the child or caregiver swipes the magnet over the device, it turns on and delivers a signal. This allows the child or caregiver to try to stop a seizure when the child feels it coming on or the caregiver sees it begin.

The procedure to implant the device is relatively minor. It takes about one hour and requires general anesthesia. Most children return home the same day.

The device battery lasts for about five years, on average. Another minor surgery is required to replace it. Our physicians have also pioneered implantation of the device under the pectoralis muscle in the chest, making it cosmetically unnoticeable.

The vagus nerve stimulator is approved by the U.S. Food and Drug Administration for use in people who are age 12 or older and have focal epilepsy that has not improved with treatment. However, because this device has been shown to benefit people younger than age 12 and those who have other seizure disorders, the procedure is offered to them as well.

This treatment can work well in children with all types of epilepsy and seizure disorders for whom medications aren’t effective. However, it is particularly well suited for children with Landau-Kleffner syndrome. Other epilepsy syndromes—such as Ohtahara syndrome, Dravet syndrome, Angelman syndrome, tuberous sclerosis, and Lennox-Gastaut syndrome—also respond well to vagus nerve stimulation.

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