A disorder in which sudden neuronal discharges cause transient dysfunction. Seizures are a phenomenon caused only by the hyper-synchronized discharge of neurons in the brain. We should learn more about it to facilitate health and life. Do you understand, let’s take a look at.
A. When do I need vagus nerve stimulation?
Epilepsy is a transient brain dysfunction disease caused by abnormal and excessive discharge of neurons in the brain, and there are many causes of abnormal brain discharge. In a study conducted by American scientists to investigate whether any causes of abnormal brain firing that lead to seizures could be found, the data published in this study showed that the first cause was still unknown, that is, no cause could be found, and the proportion was 68.7%, the second was cerebrovascular disease, accounting for 13.2%, and the rest were developmental disorders (5.5%). The rest are developmental disorders (5.5%), head trauma (4.1%), brain tumors (3.6%), infections (2.6%) and others (2.3%).
There are two characteristics of seizures in epilepsy. One is paroxysmal, which means that the brain does not have abnormal discharges twenty-four hours a day, and the other is unpredictable. People with epilepsy often have no way of knowing exactly when they will have a seizure, and therefore often suffer physical injury from seizures.
Most people with epilepsy need to take antiepileptic drugs to control the disease, but the effectiveness of medication varies from person to person and is not yet 100 percent. The percentage of patients who are well controlled on a single or multiple antiepileptic medications is about 64%. The other 36% of patients who have seizures will have seizures regardless of the type of antiepileptic medication or combination of medications they try.
Patients with epilepsy that is not well controlled by medications may consider other non-pharmacologic treatments to control their epilepsy, the most popular of which is vagus nerve stimulation.
Traditional surgical treatment of epilepsy involves finding a lesion in the brain that is discharging abnormally, and surgically removing this lesion. This method of epilepsy treatment has several limitations. First, it is an open brain surgery, which is relatively dangerous; second, the type of seizure must be localized, that is, the abnormal discharge is produced by a local area of the brain rather than a comprehensive and widespread simultaneous discharge; third, the foci of abnormal discharge can be identified; and fourth, the foci can be removed and will not cause serious complications because of the local removal of the brain. Fourth, the lesion can be removed without serious complications or sequelae due to the localized removal of the brain. The first of these is the use of the “vagus nerve stimulation” procedure, which is one of the most common treatments for epilepsy.
The vagus nerve stimulation principle.
The vagus nerve is the 10th of the 12 pairs of brain nerves in the human body and is part of the autonomic nervous system, whose function is to control the messages of the glands and internal organs. In terms of anatomical location, the vagus nerve emanates from the nucleus of the vagus nerve located in the posterior medial part of the cerebrum, passes through the jugular foramen to reach the neck, and then enters the chest and abdomen, where the vagus nerve stimulation is performed.
The theory of vagus nerve stimulation was developed by Jacob Zabarra, an American physician, in 1988.
He believed that stimulating the vagus nerve might change the electrical potential in the brain, thus blocking or even preventing seizures. The idea was later developed by Cyberonics as a neurostimulation system, NeuroCybernetic Prosthesis System (NPS).
The NeuroCybernetic Prosthesis System (NCP) was designed by Cyberonics and has been used clinically in patients with epilepsy.
The actual process of vagus nerve stimulation is as follows: first, a coil is surgically placed on the vagus nerve in the left neck and the stimulation device is buried in the chest, then at each patient visit, the medical staff adjusts the parameters and mode of the stimulation device through the instrument, and the machine automatically stimulates the vagus nerve according to the set mode to achieve seizure control. If a patient’s seizure is precipitated, when the patient feels a precursor at home or on other occasions, a small structure with a magnet inside can be used and crossed on the chest to produce additional stimulation to interrupt an impending seizure, or to reduce the duration or severity of the seizure. Currently, about 80% of patients worldwide who have used vagus nerve stimulation to help control their seizures have some improvement in their epilepsy, and 40% of patients have had their seizures reduced by half. This effect can be maintained over time, and seizure control outcomes may increase over time. In addition, some patients experience improved mood, wakefulness, and memory through vagal stimulation of the brain. It may also improve the quality of life of patients with epilepsy by reducing the amount of antiepileptic medication and the chance of being taken to the hospital for seizures.
There are some side effects associated with vagus nerve stimulation, including temporary throat rasping and pitch changes, coughing, throat tickling and shortness of breath when the machine is first adjusted, which are caused by stimulation of certain body structures that are innervated and controlled by the vagus nerve itself. Patients with long-term use have reported transient heart rhythm changes, or arrhythmias. Patients with this device should avoid short wave, microwave or therapeutic ultrasound therapy, and there is no definitive answer as to whether magnetic brain imaging will have an effect on the device.
In conclusion, the use of this non-traditional surgical vagus nerve stimulation to help control epilepsy requires a visit to a large, specialized, formal epilepsy hospital with a full epilepsy treatment team. The results need to be followed up and evaluated.
Advantages and disadvantages of vagus nerve stimulation.
The advantages are
Vagus nerve stimulation has been used by patients all over the world and has been shown to reduce seizures.
It is relatively safe and has fewer side effects than epilepsy surgery.
The effect is long-term.
The device is easy to operate.
The disadvantages are
Results vary from person to person and may not be suitable for some people (e.g., to achieve complete seizure freedom).
The price of the device is more expensive than other treatments.
Fourth, reveal the vagus nerve stimulation method illustration.
Mechanism of action
VNS is a neurocontrol device (NeuroCyberneticProsthesissystem, NCP) for treatment.
NCP) for treatment, it has a pulse generator, bipolar VNS leads, program bar and hand-held magnets.
Indications.
Patients with epilepsy between 12 and 60 years of age, focal or partial seizures secondary to generalized seizures, failure to effectively control the condition with regular treatment with one to three antiepileptic drugs, and multiple or unlocalizable lesions.
It is a good treatment for patients with significant drug side effects and inappropriate for surgery, and has good efficacy in patients with generalized seizures and pediatric epilepsy.