Vagus nerve stimulation for intractable epilepsy: a review.

Electrical stimulation of the vagus nerve in the neck by using a programmable stimulator similar to a cardiac pacemaker is being explored as a treatment for epilepsy. There is sound rationale based on studies of animal seizure models for pursuing this treatment modality, and early clinical trials provide support for efficacy in patients with intractable epilepsy at least equivalent to that of some of the new antiepileptic drugs. Safety and tolerability have been demonstrated in >800 patients worldwide since the first implant in 1988. Most of these had partial seizures for which resective epilepsy surgery was not feasible or had failed, but efficacy of vagal stimulation appears to be the same for both partial and generalized epilepsy. Specific selection criteria for this procedure have yet to be established, and further studies are warranted to determine whether vagal stimulation becomes an accepted procedure for epilepsy management.

[1]  A. Randich,et al.  Vagal afferent modulation of nociception , 1992, Brain Research Reviews.

[2]  R. Browning,et al.  Noradrenergic abnormalities in the genetically epilepsy-prone rat , 1994, Brain Research Bulletin.

[3]  E. Gellhorn.  Further experiments on the influence of afferent stimulation on cortical strychnine discharges. , 1960, Electroencephalography and clinical neurophysiology.

[4]  B. Uthman,et al.  Efficacy and Safety of Vagus Nerve Stimulation in Patients With Complex Partial Seizures , 1990, Epilepsia.

[5]  K. Till.  VIRUSES AND TUMOURS. , 1964, Lancet.

[6]  F. Dreifuss.  New Antiepileptic Drug Development , 1994, Epilepsia.

[7]  J. Lockard,et al.  Feasibility and Safety of Vagal Stimulation In Monkey Model , 1990, Epilepsia.

[8]  J. Dean,et al.  Prevention of Intractable Partial Seizures by Intermittent Vagal Stimulation in Humans: Preliminary Results , 1990, Epilepsia.

[9]  W. Ammons,et al.  Vagal afferent inhibition of primate thoracic spinothalamic neurons. , 1983, Journal of neurophysiology.

[10]  D. Morest.  Experimental study of the projections of the nucleus of the tractus solitarius and the area postrema in the cat , 1967, The Journal of comparative neurology.

[11]  R. Kuzniecky,et al.  Vagus Nerve Stimulation for Treatment of Partial Seizures: 3. Long‐Term Follow‐Up on First 67 Patients Exiting a Controlled Study , 1994, Epilepsia.

[12]  D. Woodbury,et al.  Effects of Vagal Stimulation on Experimentally Induced Seizures in Rats , 1990, Epilepsia.

[13]  J. Zabara.  Peripheral control of hypersynchronous discharge in epilepsy , 1985 .

[14]  M. Sterman,et al.  Afferent vagal stimulation: neurographic correlates of induced EEG synchronization and desynchronization. , 1967, Brain research.

[15]  P. Rutecki,et al.  Anatomical, Physiological, and Theoretical Basis for the Antiepileptic Effect of Vagus Nerve Stimulation , 1990, Epilepsia.

[16]  P. Rajna,et al.  Sensory Stimulation for Inhibition of Epileptic Seizures , 1989, Epilepsia.

[17]  R. GUERRERO‐FIGUEROA,et al.  Some Inhibitory Effects of Attentive Factors on Experimental Epilepsy , 1963, Epilepsia.

[18]  E. Agostoni,et al.  Functional and histological studies of the vagus nerve and its branches to the heart, lungs and abdominal viscera in the cat , 1957, The Journal of physiology.

[19]  R P Lesser,et al.  Placebo‐Controlled Pilot Study of Centromedian Thalamic Stimulation in Treatment of Intractable Seizures , 1992, Epilepsia.

[20]  J. Zabara.  Inhibition of Experimental Seizures in Canines by Repetitive Vagal Stimulation , 1992, Epilepsia.

[21]  J. A. Ricardo,et al.  Anatomical evidence of direct projections from the nucleus of the solitary tract to the hypothalamus, amygdala, and other forebrain structures in the rat , 1978, Brain Research.

[22]  D. Naritoku,et al.  Regional induction of fos immunoreactivity in the brain by anticonvulsant stimulation of the vagus nerve , 1995, Epilepsy Research.

[23]  A. Hamberger,et al.  Neurochemical effects of vagus nerve stimulation in humans , 1992, Brain Research.

[24]  W. Tarver,et al.  Clinical Experience with a Helical Bipolar Stimulating Lead , 1992, Pacing and clinical electrophysiology : PACE.

[25]  M Velasco,et al.  Electrical Stimulation of the Centromedian Thalamic Nucleus in Control of Seizures: Long‐Term Studies , 1995, Epilepsia.

[26]  R. McLachlan,et al.  Suppression of Interictal Spikes and Seizures by Stimulation of the Vagus Nerve , 1993, Epilepsia.

[27]  J. Slater,et al.  Vagus nerve stimulation for complex partial seizures: surgical technique, safety, and efficacy. , 1993, Journal of neurosurgery.

[28]  I S Cooper,et al.  Effect of chronic stimulation of anterior cerebellum on neurological disease. , 1973, Lancet.

[29]  O. Pompeiano,et al.  Synchronization of the EEG produced by low-frequncy electrical stimulation of the region of the solitary tract , 1961 .

[30]  D. McCreery,et al.  Considerations for Safety with Chronically Implanted Nerve Electrodes , 1990, Epilepsia.

[31]  J. Rojas.  ELECTROENCEPHALOGRAPHIC SYNCHRONIZATION RESULTING FROM DIRECT CURRENT APPLICATION TO THE VAGUS NERVES. , 1964 .

[32]  J. O. Foley,et al.  Quantitative studies of the vagus nerve in the cat. I. The ratio of sensory to motor fibers , 1937 .

[33]  G. Ricci,et al.  Changes in Interictal Focal Activity and Spike‐Wave Paroxysms during Motor and Mental Activity * , 1972, Epilepsia.

[34]  E. Ben-Menachem,et al.  Vagus Nerve Stimulation for Treatment of Partial Seizures: 1. A Controlled Study of Effect on Seizures , 1994, Epilepsia.

[35]  R. Dasheiff,et al.  Sudden unexpected death in epilepsy: a series from an epilepsy surgery program and speculation on the relationship to sudden cardiac death. , 1991, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[36]  D. Chadwick,et al.  Standard Approach to Antiepileptic Drug Treatment in the United Kingdom , 1994, Epilepsia.

[37]  M. Sterman,et al.  Cortical and subcortical patterns of response to afferent vagal stimulation. , 1966, Experimental neurology.

[38]  R. Hunt,et al.  Effects of Chronic Left Vagal Stimulation on Visceral Vagal Function in Man , 1992, Pacing and clinical electrophysiology : PACE.

[39]  Josemir W Sander,et al.  Sudden Death in Epilepsy: A Study of Incidence in a Young Cohort with Epilepsy and Learning Difficulty , 1995, Epilepsia.

[40]  M. Salinsky,et al.  Vagus Nerve Stimulation Has No Effect on Awake EEG Rhythms in Humans , 1993, Epilepsia.

[41]  Lippincott Williams Wilkins,et al.  A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures , 1995, Neurology.

[42]  E. Fallen,et al.  Neurocardiac Responses to Vagoafferent Electrostimulation in Humans , 1992, Pacing and clinical electrophysiology : PACE.

[43]  B. Uthman,et al.  Electrophysiological Studies of Cervical Vagus Nerve Stimulation in Humans: I. EEG Effects , 1992, Epilepsia.

[44]  A. Foutz,et al.  Characteristics of the experimental reflex sleep induced by vago-aortic nerve stimulation. , 1977, Electroencephalography and clinical neurophysiology.

[45]  A. Zanchetti,et al.  The effect of vagal afferent stimulation on the EEG pattern of the cat. , 1952, Electroencephalography and clinical neurophysiology.

[46]  J. Zabara,et al.  An Implantable Neurocybernetic Prosthesis System , 1990, Epilepsia.

[47]  B. Uthman,et al.  Vagus Nerve Stimulation for Treatment of Partial Seizures: 2. Safety, Side Effects, and Tolerability , 1994 .

[48]  The conditioned inhibition of uncinate fits. , 1957, Brain : a journal of neurology.

[49]  R. Jung.  Blocking of Petit‐mal Attacks by Sensory Arousal and Inhibition of Attacks by an Active Change in Attention during the Epileptic Aura * , 1962 .

[50]  M Velasco,et al.  Electrical Stimulation of the Centromedian Thalamic Nucleus in the Treatment of Convulsive Seizures: A Preliminary Report , 1987, Epilepsia.

[51]  C. Arseni,et al.  Electro‐Clinical Investigations on the Role of Proprioceptive Stimuli in the Onset and Arrest of Convulsive Epileptic Paroxysms , 1967, Epilepsia.

[52]  J. Murphy,et al.  Left vagal nerve stimulation in children with refractory epilepsy. Preliminary observations. , 1995, Archives of neurology.