Type of Surgery
Last updated: 02/17/2009
Devinsky, O. A Guide to Understanding and Living withEpilepsy. Philadelphia: E. A. Davis, 1994.
"Seizure Disorders." Section 14, Chapter 172 in The MerckManual of Diagnosis and Therapy,...
edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.
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
Select comparative data from 1999 to 2006 include a decrease of 14 percent in the number of neurosurgeons in private practice and a decrease of 13 percent in the number of neurosurgeons in solo practice.
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