Type of Surgery
Last updated: 02/17/2009
Implantation of the stimulator in an adult may be performed as either an outpatient or inpatient procedure. In the latter case, the patient will remain in the hospital overnight for monitoring of heart function and other vital signs. Children...
who are receiving a VNS are usually scheduled for an overnight stay. Pain medication is given as needed.
The stimulation parameters are adjustable, and the neurologist may require several visits to find the right settings. Settings are adjusted with a magnetic wand that delivers commands to the stimulator's computer chip. The patient may be taught how to use a magnet to temporarily increase stimulation, to prevent a seizure, or to abort it once it begins.
The VNS generator is powered by a battery that lasts several years. It is replaced during an outpatient procedure under local anesthesia.
Vagus nerve stimulation (VNS) is an adjunctive treatment for certain types of intractable epilepsy and major depression. VNS uses an implanted stimulator that sends electric impulses to the left vagus nerve in the neck via a lead wire implanted under the skin.
Vagus, the tenth cranial nerve arises from the medulla and carries both afferent and efferent fibers. The afferent vagal fibers connect to the nucleus of the solitary tract which in turn projects connections to other locations in the central nervous system. Little is understood about exactly how vagal nerve stimulation modulates mood and seizure control but proposed mechanisms include alteration of norepinephrine release by projections of solitary tract to the locus coeruleus, elevated levels of inhibitory GABA related to vagal stimulation and inhibition of aberrant cortical activity by reticular system activation
Even patients who had a single metastasis surgically removed should have radiation therapy as there are always individual tumor cells remaining.
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