Epilepsy Talk

TNS vs. VNS – NO SURGERY! | April 1, 2013

The first Vagus Nerve Stimulator (VNS) was implanted in 1988, as a therapeutic option for medically intractable epilepsy, when elective epilepsy surgery was not appropriate.

As the number of implanted vagus nerve stimulators grows, so does the need to remove or revise the devices.

Which is a little tricky, because of the spiral stimulating electrodes, wrapped around the nerve. Especially if the VNS treatment has proven ineffective.

And of course, what goes in, must come out. Anyway you look at it, there’s more surgery involved.

The up side to having a VNS is better seizure control.

The down side is discomfort, headaches, temporary hoarseness and shortness of breath.

Meanwhile, the success rate is iffy. Studies have shown that:

About 1/3 of patients have had the number of their seizures reduced by half or more; less than 5% of patients become seizure free…

About 1/3 have shown benefit but have had their seizure frequency reduced by less than half…

About 1/3 have had no worthwhile benefit.

On the other hand, Trigeminal Nerve Stimulation is a new nerve stimulation therapy that requires NO SURGERY and reduces seizures among those who are drug resistant by about 40 percent.

A recent clinical trial showed that at the end of the 18-week study, 40 percent of patients receiving TNS experienced a significant improvement in seizure reduction.

The TNS system has two components: a hand-held pulse generator — which is about the size of a cell phone — that creates the electrical signal and a disposable custom electrical patch — much like a gel pad — that delivers the signal to its target, the trigeminal nerve.

Because it is a large sensory nerve, the trigeminal offers a high-bandwidth pathway for electrical signals to enter the brain.

All you have to do is apply the gel-like electric pads to your forehead and connect them to the pulse generator. The only sensation you may feel is a mild “tingling” sensation.

“The device is appealing because it doesn’t require surgery, doesn’t have side effects and is very easy to use,” says Jennifer Rees, 49, who lives in the Los Angeles area and has been using the nerve stimulator for six years as part of a test group.

She wears her patches while sleeping, putting one gel pad above each eyebrow. And…

“For me it’s extremely effective.” Rees says that before using the stimulator, she was having up to eight seizures a month.

The device alone reduced that to about one seizure a year.

And she hasn’t had any seizures since she added low doses of a medication more than 18 months ago.

Soon to be approved by the FDA, hopes are high.

Because, it could offer an alternative or enhancement to treatment with drugs,says Christopher DeGiorgio, the neurologist at UCLA who invented the new approach.

DeGiorgio said: “I’m encouraged to see that our non-invasive and safe approach to neuromodulation compares favorably to pharmaceutical and surgically implanted  device therapies of drug-resistant epilepsy.”

And one more piece of good news: In some studies on patients with depression and post traumatic stress disorder, the patch resulted in a 70 per cent reduction in symptoms!

To subscribe to Epilepsytalk.com and get the latest articles by email, simply go to the bottom box of the right column and click on “Follow.”

Other articles of interest:

Vagus Nerve Stimulation…Is it for YOU?  https://epilepsytalk.com/2011/03/13/vagus-nerve-stimulation%E2%80%A6is-it-for-you/

The Gamma Knife — Non Invasive Surgery  https://epilepsytalk.com/2012/09/12/the-gamma-knife-non-invasive-surgery/

Laser Surgery — New Breakthrough Epilepsy Treatment!  https://epilepsytalk.com/2011/07/19/breakthrough-surgery-for-those-with-epilepsy/

Responsive Neurostimulation (RNS) Shown to Reduce “Untreatable” Seizures  https://epilepsytalk.com/2013/05/05/responsive-neurostimulation-rns-shown-to-reduce-untreatable-seizures-3/

Trigeminal Nerve Stimulation — A Breakthrough Technology Reducing Seizures by Up to 66%   https://epilepsytalk.com/2013/03/24/trigeminal-nerve-stimulation-a-breakthrough-technology-reducing-seizures-by-up-to-66/

To subscribe to Epilepsy Talk and get the latest articles, simply go to the bottom box of the right column and click on “Sign me up!”

Resources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345590/

http://www.epilepsy.org.uk/info/treatment/vns-vagus-nerve-stimulation

http://epilepsy.med.nyu.edu/diagnosis-treatment/vagus-nerve-stimulation-vns

http://www.npr.org/2011/07/27/138619259/new-device-reduces-seizures-no-surgery-required?ft=1&f=100

http://www.telegraph.co.uk/health/9670357/Doctors-give-a-cautious-welcome-toepilepsy-patch.html

http://www.epilepsyfoundation.org/news/Unique-Nerve-Stimulation-Treatment-Proves-Effective-Against-Drug-Resistant-Epilepsy.cfm

http://www.news-medical.net/news/20120914/Trigeminal-Nerve-Stimulation-an-interview-with-Dr-Leon-Ekchian-President-and-CEO-of-NeuroSigma.aspx


4 Comments »

  1. Hi,
    I had my VNS implant in 1/2010 & I’m not a fan being on 24 pills a day & Tonic/Clonic, Clusters every 4 mos.
    Now I’m developing trouble swallowing (VNS related) & can’t get pills down due to nerve damage done by VNS.
    ** Did you know with a VNS your life can never be saved with the Electric paddles (Jump Start)?!
    The VNS can also cause permanent Tinnitus & balance problems from nerve damage.

    ** Do take Super Complex B if you go the VNS route! 😊

    Given a choice I’d stick with pills, they’re easier to stop/remove!

    Like

    Comment by Rosie McKeever — November 20, 2014 @ 12:42 PM

  2. I don,t think that would be good for me, with what I went through I don,t know.

    Like

    Comment by michele metzger — April 1, 2016 @ 6:23 PM

  3. Maybe it’s worth it to talk with your neuro about? Or not.

    Like

    Comment by Phylis Feiner Johnson — April 1, 2016 @ 7:27 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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