Vagus Nerve Stimulation

What is vagus nerve stimulation?

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Vagus nerve stimulation is simply the use of a device to stimulate the vagus nerve with electrical impulses. There’s a vagus nerve on each side of our body, running from our brainstem through our neck to our chest and abdomen.

Types of vagus nerve stimulation

There are two ways to carry out a vagus nerve stimulation. This can either be an invasive method – that is through implantation of a pulse generator in the chest – or making use of a non-invasive device.

• Invasive device: A pulse generator is implanted in the chest, and through the vagus nerve, it is used to send pulse signals to the brain. This is the most traditional form of vagus nerve stimulation and the procedure for treating drug-resistant epilepsy.
• Non-invasive device: Non-invasive vagus nerve stimulation devices could serve as an option for people who don’t want a vagus nerve stimulation device inserted into their bodies. 

Why is a vagus nerve stimulation requested? 

Around one-third of people suffering from epilepsy don’t fully respond to anti-seizure drugs. Vagus nerve stimulation may serve as an option to reduce the frequency of seizures in those who haven’t achieved control with medications.

Vagus nerve stimulation may also be helpful in treating people who haven’t responded to intensive depression treatments, like antidepressant medications, psychological counselling (psychotherapy) and electroconvulsive therapy.

Preparation for a vagus nerve stimulation

Before embarking on a vagus nerve stimulation procedure, it’s important to carefully consider the pros and cons of the implanted device. 

Alternate treatment choices should be considered before making the final decision on vagus nerve stimulation and be sure it’s actually the best option for you. Also, discuss with the doctor what you should expect during surgery and after the pulse generator has been put in place.

You may need not to eat the night before the procedure, and may even need to stop taking certain medications ahead of time

Vagus nerve stimulation procedure

Before the commencement of a vagus nerve stimulation procedure, physical examinations and some tests may need to be carried out to ensure there is no health concerns that might be a problem. Patients may also have to start taking antibiotics before the surgery to prevent infection.

During the procedure

• The surgery roughly takes 1 hour to 1 hour and 30 minutes, and it’s carried out under a local anaesthesia or general anaesthesia.
• Two incisions are made; one is made on the chest or in the armpit region, and the other is made on the left side of the neck.
• The pulse generator device is implanted in the upper left side of the chest. Although, this implant is permanent, it can, however, be removed if necessary. The size of the implanted device is about the size of a stopwatch and runs on a battery power. 
• A lead wire is then connected to the pulse generator device. The lead wire is guided under the skin from the chest up to the neck, where it’s joined to the left vagus nerve through the second incision.

Aftermath of a vagus nerve stimulation procedure

Few weeks after the surgery, the pulse generator device is turned on to be programmed to deliver electrical impulses to the vagus nerve at different durations, frequencies and currents. It ordinarily starts at a low level and gradually increased, depending on the symptoms and side effects.

The stimulation is also programmed to turn on and off in specific cycles; for instance 30 seconds on, five minutes off. The turning on of the nerve stimulation may cause some tingling sensations or slight pain in the neck and temporary hoarseness.

Result of a vagus nerve stimulation

Vagus nerve stimulation isn’t a permanent cure for epilepsy, and most people with epilepsy who undergo vagus nerve stimulation won’t stop having seizures or stop taking epilepsy medication after the procedure. But many of them will have fewer seizures occurrence, about 20 to 50 percent. Seizure intensity may also lessen.

It may, however, take months or even years of stimulation before noticing any significant reduction in seizures. 

Vagus nerve stimulation may also reduce the recovery time after a seizure episode.

People who undergo vagus nerve stimulation to treat epilepsy may also experience some improvements in mood and quality of life.

FAQs

Are there any complications from a vagus nerve stimulation surgery? 

Surgical complications from vagus nerve stimulation surgery are very rare but are similar to the dangers of having other types of surgery. Possible complications from a vagus nerve stimulation surgery are;

• Pain at the site incision.
• Infection.
• Difficulty swallowing.
• Vocal cord paralysis. Although, usually temporary, but can also be permanent.

What are vagus nerve stimulation side effects? 

Some of vagus nerve stimulation side effects and associated health problems may be:

• Voice changes.
• Hoarseness.
• Pain in the throat.
• Cough.
• Headaches.
• Shortness of breath.
• Difficulty swallowing.
• Tingling or prickling of the skin.
• Insomnia.
• Worsening of sleep apnea.

What foods stimulate vagus nerve? 

The EPA and the DHA found in seafood stimulate the vagus nerve to increase the variability of heart rate. These effects can as well result from a fish oil supplement. 

Yoga also increases vagus nerve and parasympathetic system activity.

Can anxiety trigger vagus nerve?

Anxiety is one of the other problems that has been linked with vagus nerve dysfunction.

What are the likely vagus nerve stimulation symptoms?

Likely symptoms of the damage of a vagus nerve include:

• Speaking difficulty or loss of voice.
• Hoarse or wheezy voice.
• Trouble with drinking liquids.
• Loss of gag reflex.
• Pain in the ear.
• Unusual heart rate.
• Abnormal blood pressure.
• Decreased production of the stomach acid.

What are the likely vagus nerve stimulation benefits?

Some of the likely vagus nerve stimulation benefits are:

• Treatment for Seizures and Depression: Vagus nerve stimulation is recommended alongside anti-epileptic drugs for people with epilepsy. It helps to reduce the frequency, severity and intensity of seizures. It may shortens the recovery time from a seizure episode. This may actually not work for everyone. Vague nerve stimulation has also proven to be beneficial for people living with chronic depression who are not responding to antidepressants and therapy.
• Chronic Depression: Vagus nerve stimulation helps to improve depression symptoms through stimulation of the production of certain neurotransmitters in the brain. Many people with depression have reported seeing significant improvement in their depressive symptoms months after they begin vagus nerve stimulation treatments. This also doesn’t work for everybody.