Vagus nerve stimulation for control of intractable seizures in childhood

Vagus nerve stimulation (VNS) is gaining increasing popularity and credibil ity as a treatment option for children with intractable epilepsy, VNS offer s several advantages over extant treatments. Its efficacy is maintained dur ing prolonged stimulation, and seizure control actually improves with time. There is no associated cognitive impairment and no adverse drug interactio ns. Unlike cerebral surgery, VNS is a potentially reversible form of therap y. The computer-controlled characteristic of the device perm its complete a nd involuntary treatment compliance. VNS is safe and well-tolerated, Its si de effects are generally transient and mild, and no physiologic perturbatio ns have been reported despite extensive monitoring. Serious adverse events are rare, and no deaths have been attributed to VNS therapy itself or to th e technique of surgical insertion. In this article, we discuss the theoreti cal background behind VNS and review the clinical studies that substantiate its long-term safety, feasibility, tolerabiiity and potential efficacy in children with refractory epilepsy.