[Vagus nerve stimulation therapy for epilepsy].
نویسنده
چکیده
Vagus nerve stimulation is a palliative treatment for medically intractable epilepsy. This treatment reduces the frequency and severity of seizures refractory to antiepileptic drugs. Implanted generator and helical electrodes electrically stimulate the left vagus nerve at the neck chronically and intermittently. This was the first electrostimulation therapy clinically introduced for epilepsy. This treatment approach is supported by randomized double-blind trials even though the anti-seizure effect of vagus nerve stimulation is palliative and not curative. In Western countries, particularly the United States, this therapy has become an important alternative treatment for a subpopulation of patients with drug-resistant seizures who are not good candidates for craniotomy. In Japan, vagus nerve stimulation therapy was finally approved in January 2010 and has been covered by public health insurance since July 2010. Here, the author reviews the history, efficacy, and safety of this treatment, surgical anatomy and physiology of the vagus nerve, and the putative mechanisms underlying inhibition of epileptic seizures and accompanying effect on the central nervous system. Further experimental and clinical studies regarding this treatment approach are required to elucidate the detailed mechanism of action, to clarify the predicting factors of favorable outcome, and to scientifically confirm the anti-seizure effect in children and in generalized seizures and the efficacy in improvement of cognitive function, development, and quality of life.
منابع مشابه
Vagus nerve stimulation in the treatment of nervous system disease: a review article
The vagus nerve (VN), the longest cranial nerve and an essential part of the parasympathetic system, connects the central nervous system to respiratory, cardiovascular, immune, gastrointestinal, and endocrine systems and is involved in the maintenance of homeostasis by controlling these systems. Vagus nerve stimulation (VNS) is related to any method that would stimulate the vagal nerve via elec...
متن کاملVagus nerve stimulation for refractory idiopathic generalised epilepsy
We reviewed our experience with vagus nerve stimulation (VNS) in 165 patients with medically refractory epilepsy (138 partial epilepsy (PE), 13 symptomatic generalised epilepsy (SGE), 14 idiopathic generalised epilepsy (IGE)). Average duration of VNS therapy was 21.6 months. A 50% or greater reduction in seizure frequency was achieved in 47.1% of the PE group, 46.1% of the SGE group, and 57.1% ...
متن کاملNeurostimulation as a Treatment Option for Epilepsy
Vagus Nerve Stimulation Electrical stimulation of the 10th cranial nerve or vagus nerve stimulation (VNS) has become a valuable option in the therapeutic armamentarium of adults and children with refractory epilepsy. Since its introduction in 1989 over 50,000 patients have been treated with VNS worldwide. Efficacy, side effects and tolerability have been extensively studied. The precise mechani...
متن کاملNeurostimulation for epilepsy, including a pilot study of anterior nucleus stimulation.
Epilepsy is a common disorder, affecting approximately 0.7% of the population of the United States and of the world. The mainstay of therapy is medication, but only approximately two-thirds of individuals with epilepsy come under satisfactory control with medications (22). Some whose epilepsy cannot be medically controlled can be cured or substantially improved by resective surgery. However, th...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Brain and nerve = Shinkei kenkyu no shinpo
دوره 63 4 شماره
صفحات -
تاریخ انتشار 2011