Epilepsy Talk

TNS vs. VNS – NO SURGERY! | September 15, 2021

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 nerve stimulation therapy that requires NO SURGERY and reduces seizures among those who are drug resistant by about 40 percent.

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.

ory 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 t

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

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!

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Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874575/

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

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

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

https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/external-trigeminal-nerve-stimulation


10 Comments »

  1. I want to try this so bad! Is this something that insurance would cover?

    Liked by 1 person

    Comment by Amy — September 15, 2021 @ 6:00 PM

    • I really don’t know. But I think something that’s not “regular” therapy, is not likely to be covered.

      Like

      Comment by Phylis Feiner Johnson — September 16, 2021 @ 9:36 AM

  2. Why doesn’t every neurologist talk about this TNS ? Is it in every part of the country that anyone can get it ? I would have to believe it would be available in Baltimore at JHMU. or at the University of Maryland or at Mercy Medical Institute.

    Liked by 1 person

    Comment by James D — September 15, 2021 @ 6:07 PM

  3. Did you see this William? TNS sounds like a possibility…

    Liked by 1 person

    Comment by Julie Wegscheid — September 15, 2021 @ 10:24 PM

  4. I just want you to know the work you do is appreciated Thank you very much

    Sent from my iPad

    >

    Liked by 1 person

    Comment by Leonard Hamilton — September 16, 2021 @ 12:37 AM

  5. I’m certainly grateful for my VNS. The trade off I have is certainly greater strain on my voice. It was already impacted by brain surgeries. It does a fabulous job with mood boosting!! That’s why we selected it over the DBS. Anyways, when it comes to this TNS, if a patient wants 24/7 protection, it appears then one has to wear the pads on their forehead longer than just during sleep. Wonderful though, to have protection from nocturnal seizures. My nocturnals haven’t expanded to tonic-clonics since my surgeries. They do, however cluster during sleep.

    Liked by 1 person

    Comment by Leda — September 16, 2021 @ 5:45 PM

    • Thanks Leda for explaining the variety of options and your experiences with them. I think it’s important “not to throw away the baby with the bath water” and also, to realize that it takes more than one try (as you proved) to “get it right”.

      Like

      Comment by Phylis Feiner Johnson — September 16, 2021 @ 9:03 PM

  6. Providing some control over the treatment options for seizures, the TNS looks & sounds better & safer alternative to VNS or brain surgery that every Neurologist, brain surgeon, hospitals & insurance companies should make it available option to the patients seeking remedy to their seizures, before applying any risky & evasive measures to control the seizures.
    Making the information available to general public, the VNS treatment could certainly help more patients to decide on their treatment options, with more confidence, convenience & zero side effects.
    Let’s hope the treatment is available & accessible to all who need it.
    Gerrie

    Liked by 1 person

    Comment by Gerrie — September 16, 2021 @ 6:36 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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