In this procedure, the vagus nerve is stimulated with electrical impulses wherein the vagus nerve stimulating device sends electrical impulses along the vagus nerve to the brain.
This procedure is used in epileptic patients who are not responding to other methods of treatment. It is also used in treatment of chronic depression where other treatment modalities have not been useful.
It is believed that this procedure can be useful in treating other conditions like anxiety disorders, migraine and alzheimer’s disease.
Physical examination is done. Blood tests are carried out. Antibiotics are started prior to the surgery to minimize risk of infections. Certain blood thinning medications that the patient might be taking will have to be stopped as and when advised by the treating doctor.
Vagus nerve stimulation is done by a surgeon usually as an outpatient procedure. Sometimes an overnight stay may be required for observation.
It takes one to two hours to complete the procedure. The procedure is performed under general anesthesia.
Vagus nerve stimulating device is surgically placed / implanted under the skin of the chest. The device has a battery and lead wires. An incision is made in the upper left chest and the device is implanted under the left clavicle/shoulder bone. Another incision is made in the neck to access the vagus nerve and the lead wires are wrapped around the left branch of the vagus nerve.
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Risk and Complications
Surgical complications include infection, pain and incision scarring.
Cardiac arrhythmia may be caused. Increase in vagal tone will result in decrease in respiratory flow causing sleep apnea.
The laryngeal nerves may be affected resulting in hoarseness of voice, voice alteration, cough, throat pain, etc.
Some patients also complain of headache, chest pain, nausea & vomiting and difficulty in swallowing.
The right branch of the vagus nerve is not stimulated because it can interfere with the cardiac function.
Vagus nerve stimulation only aims to reduce the length and severity of seizures; it does not completely cure epilepsy.
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