Type of Surgery
Last updated: 02/17/2009
A candidate for vagal nerve stimulation will have had many tests already to determine the focal point of seizure activity. Preoperative tests include neuroimaging as well as psychological tests to determine the patient's cognitive (thinking) strengths...
The patient must be fully informed about VNSâ€”how it works, its advantages and disadvantages, what will happen during surgeryâ€”before the operation is scheduled. A video as well as written material about VNS is available to view and discuss with the doctor.
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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