How is it performed and what is involved?

The vagal nerve stimulation system is a painless system that is positioned inside the body. It is implanted surgically under a general anaesthetic. It consists of a small electrical device connected to tiny electrical wires called electrodes.

The electrical device is similar to a pacemaker and is placed under the left collarbone, while the electrodes are placed in the neck near the vagus nerve. Electrical impulses are sent through the electrodes to the vagus nerve, the settings of which are adjusted for each patient’s requirements.

If the vagal nerve stimulation system is used to treat seizures, then a small magnet can be passed over the system to activate the electrical signal. This can be used to dampen an oncoming seizure and is particularly useful if there is a warning aura or sensation before the fit or seizure occurs.

Alternatively, the magnet can be used to shorten the duration of an on-going seizure. The London Clinic’s leading specialist epilepsy team can guide patients and their carers on how best to use the vagal nerve stimulation system.

For certain headaches and neuropsychiatric conditions, non-invasive vagal nerve stimulation systems are a new and effective treatment option. These are controlled by the patient and have an electrical device that is placed outside the body, along the surface of the neck.

The non-invasive vagal nerve stimulation is intended for use multiple times a day; our expert teams will advise on how many times, how often and when it should be used.

What are the risks?

Vagal nerve stimulation is a relatively safe procedure and there have been no serious device-related problems reported with non-invasive vagal nerve stimulation. As with any procedure there are small risks involved.

About 1 in 3 patients may experience mild voice changes in the first few months after surgery, but this tends to settle with time. Other risks can include:

• A persistent cough
• Some shortness of breath
• Numbness at the site of insertion
• Temporary slowing of the heart rate during implantation
• An infection or collection of blood at the insertion site (this may require another procedure to correct).

The main consideration of non-invasive vagal nerve stimulation is that it may not adequately treat the condition.

Our specialist team here at The London Clinic are committed to ensuring the most optimised care throughout the treatment.

How effective is it?

A number of studies have looked at the effects of vagal nerve stimulation in the treatment of epilepsy, particularly in partial seizures in children.

Results have shown that at least half of the patients treated with vagal nerve stimulation experienced a reduction of seizure frequency by at least 50%. In adults, results were similar and there were even some patients (5 - 8%) who became seizure-free.

There is also some new evidence for the use of vagal nerve stimulation for the treatment of headaches. Headache improvement is usually seen within 1-3 months of implanting the vagal nerve stimulation system.

The use of non-invasive vagal nerve stimulation has been found to effectively prevent the occurrence, as well as reduce the symptoms, of chronic cluster and migraine headaches. In some studies, approximately 40% of patients who received non-invasive vagal nerve stimulation for their headaches experienced a >50% reduction in frequency.