Positioning of vagal nerve stimulators: Technical note

BACKGROUND Vagal nerve stimulation has become an important treatment for patients with intractable seizure disorders. Many of these patients will require magneti c resonance imaging (MRIs) of the brain after the stimulator has been impla nted to monitor underlying neurologic conditions. Functional MRI (fMRI) is also being used in the evaluation of epilepsy. With the current recommended implant techniques the magnetic field of the MRI will deactivate the pulse generator while the patient is in the supine position for the scan. A simp le change in positioning of the pulse generator will help to avoid deactiva ting the device during an MRI. This will avoid exposing the patient to leng thy time periods with a deactivated stimulator and also allow for the perfo rmance of fMRIs and any other MRI scans needed to monitor underlying neurol ogic conditions. METHODS A working model of the NeuroCybernetic Prosthesis (NCP(R)) pulse generator was assessed with an oscilloscope and LED light connected to it that relate d activation of the generator while in the MRI. This simulation was perform ed with the device alone, in multiple positions. Then patients with implant ed devices who could personally confirm the activation of their stimulators were also studied. RESULTS A pulse generator placed with the electrode inputs parallel to the long axi s of the body was not deactivated by the magnetic field of the MRI when the patient was in the supine position. CONCLUSION Changing the implant position of a vagal nerve stimulator pulse generator w ill help to prevent deactivation of the device while in the MRI, allowing f or the performance of fMRIs while not exposing the patient to lengthy time periods with a deactivated vagal nerve stimulator. (C) 2000 by Elsevier Sci ence Inc.