VNS developments bring chance of better treatment
Epilepsy New technology could make it easier to predict which patients could benefit from vagus nerve stimulation to reduce fits and ensure it is delivered more effectively.
New technology could bring better treatment for epilepsy patients using vagus nerve stimulation (VNS). VNS Therapy consists of a small, pacemaker-like device the size of a small watch that is implanted into the upper chest. A thin wire connected to the device runs under the skin and attaches to the left vagus nerve in the neck. The device delivers mild, intermittently-pulsed signals at regular intervals to stop excessive electrical activity in the brain that causes seizures
“In around a third to two-thirds of VNS users seizures are reduced,” says Mr Ramesh Chelvarajah, consultant neurosurgeon at Birmingham University Hospitals NHS Trust.
The treatment is offered when anticonvulsant medication fails to keep seizures under control, but surgery is ruled out. Using the present technology patients have the opportunity to activate the device themselves as well as normal background stimulation.
The new device senses the rise in heart rate that happens concurrently with a fit and cuts in to deliver VNS automatically. “Trials are under way and after assessments I expect this to be available on the NHS,” says Mr Chelvarajah.
While VNS and other neuromodulatory techniques can reduce fits, surgery can deliver the chance of a cure. “Up to four-fifths of patients with epilepsy caused by hippocampal sclerosis can be cured by surgery,” says Mr Chelvarajah.
Access to assessment and treatment
However, he says: “Thousands of people are not getting the assessment and treatment they should have. A 2010 survey by Epilepsy Action found that 73 percent of people with refractory epilepsy are not seen in the complex epilepsy and surgery service. This is unfortunate, because treatments that reduce or stop fits would save the NHS money and improve many lives.”