Epilepsy Talk

TNS vs. VNS — NO SURGERY! | July 11, 2022

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.

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.

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!

Now, that’s a win-win…

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Resources:

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/treatment/devices/external-trigeminal-nerve-stimulation

https://tmslosangeles.com/tns-trigeminal-nerve-stimulation/

https://www.uclahealth.org/news/unique-nerve-stimulation-device-proves-effective-against-epilepsy

https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-medical-device-treatment-adhd


12 Comments »

  1. Reblogged this on Disablities & Mental Health Issues.

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    Comment by Kenneth — July 11, 2022 @ 10:01 AM

  2. […] Source link […]

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    Pingback by TNS vs. VNS — NO SURGERY! – Richard Pearce — July 11, 2022 @ 5:29 PM

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    Pingback by TNS vs. VNS — NO SURGERY! – My Blog — July 11, 2022 @ 6:09 PM

  4. It is nice in knowing about *Other Choices. Since June 13, 2022, I was connected for “5 day in hospital stay” to an EEG. *Some evidence was found. Ever since, *I Have Been WAITING to have an appointment for surgery, having what is called a *NEUROSPACE RNS System implanted in my brain. *It Is Taking FOREVER just to get an appointment for surgery! My next “Talking Appointment,” ONLY is on August 1, 2022. In the mean time, “The Clock Is Ticking!”
    I was given the impression that this *WILL stop ALL “blackouts.” For me, *Temporal Lobe Epilepsy. I would So MUCH like to get out of This PRISON I live in! I’ve been here since June, 1988 and can only go somewhere *IF “The Husband” takes me. A few minutes ago, *Joe left for *his Fiction “Writer’s” Group Meeting, for which I am never invited! Earlier, I hinted about being dumped off at the shopping center across from where he will be. Didn’t matter! It’s *his night out!

    I haven’t been to a beach but 1 time since The 1970’s! This was in the early to mid 1980’s when a lady friend picked me up in her new car to drive *100 miles to Virginia Beach. That’s ALL! Just 100 miles! Joe Erhardt has never taken me ANYWHERE outside of visiting his parents in Newport News, Va.–when they were alive. No Honeymoon, No Vacations–NOTHING outside of going to a restaurant, where he “stuffs his gut!” He’s A *NARCISSIST! But, hey. “It’s Just Me.” As long as nobody else is in this “relationship,” No Big Deal. Right?
    If I do not opt out of this surgery due to constantly WAITING Forever–If I go Seizure Free, I shall get me a Legal Driver’s License, pray for someone to give me a car and I WILL Go To The Beach, ALONE! I’ve been alone for 40 years of so-called, “Marriage!” Just like he walked out the front door, *leaving me behind, I will So Do It To Joe Erhardt! Animals are treated better.

    Yes. Some of us are WILLING to take a chance to have our scalp cut and moved back in order to have the *skull cut open, having a device implanted with one wire at the Left Temporalobe, second wire at the Right Temporal Lobe, that is SAID to give one “A LIFE–Seizure Free!” Although the battery needs to be changed every 10 years, I’m already 71 years old. I don’t expect to go back for another surgery with NO Support. I Just Want To Be Free for what time I have left.
    Everyone have a nice day in “Existing With Epilepsy.” I know there are many other people with “The ‘E’ Word” who ARE Loved And Cared For by *Normal People. Mine just isn’t one of them.

    Liked by 2 people

    Comment by Effie Erhardt — July 11, 2022 @ 7:22 PM

  5. Oh Effie. It sounds like your hurt is by a thousand tiny cuts. So many insults, so much negligence. No, I don’t think an operation will change this. Unless is an operation to heal a broken heart.

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    Comment by Phylis Feiner Johnson — July 11, 2022 @ 9:36 PM

  6. had one put in, my epilepsy went through the roof, I never did work out how you could activate it as I pass out immediately with no auras, then had had it removed by a surgeon who was tired and had other surgery to do, so he left in the wires, I can’t have MRIs any longer and I have needed them for an accurate diagnosis of other conditions.

    Liked by 2 people

    Comment by Gail Barry — July 12, 2022 @ 7:09 AM

  7. This E-word…how I wish I could get rid of it! People judge, people assumes the other way…But, I still hope there are better days to come!

    Liked by 1 person

    Comment by Thuam Siam Ngaihte — July 14, 2022 @ 1:40 AM

  8. Last week, I called and CANCELLED the surgery “Talking Appointment” and anything following. As of now, I have no plans “getting surgery on my brain.”
    When in hospital for a 5 Day EEG, I had NO “Blackouts!” I was released on Friday, June 17, 2022. The VERY Next Day, I had a “Blackout!” Another 2 days later. I’ve had at least 7 since coming home, along with So MANY Auras, I don’t keep count! Today has been very bad.

    When in the hospital, they started to *Decrease me off of ALL Anti-seizure Meds! ***Even my *2 Daily Pain Pills! I was on an Elevated bed. So I didn’t feel so much pain while in the Elevated Bed. But as SOON as I got home, PAIN “Hit The Roof!” I am STILL trying to “Play ‘Catch Up!'” With *Neuropathy and *Fibromyalgia from my back down to my feet, it sometimes takes me 1 to 2 hours Just To WALK, when getting out of bed in the mornings. The thought of having Brain Surgery only for my lower body to “give way on me” became a reality.

    And when going to *The Pain Center, people there ALWAYS try to make me feel like *I’m Selling The Pills! SERIOUS! Just today, I got a Statement of my Last Visit to *The Pain Center. ***They Charge $450.00 For EACH, Monthly Appointment! My husband calls this, “Funny Money” that they apply for with Medicare. Not that they GET All of This. But *It’s The Principle! We have a $20.00 Co-Pay for appointment. SO–Joe thinks they STILL get around $160.00 EACH Appointment!!! The last $20.00 being what we pay. THEN we buy the pills for “whatever price!” My next monthly appointment is on July 25, 2022.

    It would have been nice to have known *In Advance how I was going to be “treated.” EVERY time I needed to go to the bathroom, I had to Press A Button, letting other workers know. They would Unhook me and hold some of the wiring JUST Outside the door, when I *was trying to urinate! Serious! I have also lost a LOT of hair from “The Tug And PULL” from wires! I still lose a lot of hair every time when showering. Anyway, it “was an experience.”

    I will NOT be getting a *NEUROPACE installed in my brain–especially when having to have a new battery installed Every 10 Years! No Thank You. Just the thought of this surgery has given me a different perspective on “Trying To Be Free.” I’m now 71 years old. I do not wish having that experience a Second Time at age *81–assuming I am still alive.

    I understand that my Pastor contacted someone on Facebook, asking them about my epilepsy. Toney is going to mail them information for the church members to *Learn About Epilepsy. This Past Sunday, I had a STRANGE “blackout.” Sounds like I’m going to teach others in a different way about *Having Epilepsy.

    Thanks for letting me *have The Freedom in writing all this. There was a time when I couldn’t have written a sentence. Everyone else have a GOOD, Rest of The Week. God Bless. ❤

    Effie Jane

    Liked by 1 person

    Comment by Effie Erhardt — July 18, 2022 @ 11:42 PM

    • Effie, I know this may sound trite, but have you tried Gabapentin for the neuropathy? My husband has neuropathy from his neck down to his toes and is in constant pain. This helps, along with Lidocaine injections (at his pain management center) and also Lidocaine patches. Hope this is of help.

      Like

      Comment by Phylis Feiner Johnson — July 19, 2022 @ 9:35 AM

  9. Phylis,

    Thank you for your kind reply. 😮 From The Neck, Down? OUCH!
    I asked Joe, since he remembers every pill and incident better than me. When it was called, *Neurontin, I broke out in a rash and had to stop taking. I’ve also had injections–*In The Hip, Only, and every 6 months, *Only. Wish there was one for my feet! Joe said the Dr. at Pain Center once gave me a One-Time-Only 100Mg. prescription for Gabapentin. There was later a prescription for *300Mg. Gabapentin! It was suggested by my Now, Epileptologist, to Not Take.

    I used to use Pain Patches. One time, I had up to 6 or 7 on one side, going down leg–even on top of foot. Joe kept fussing on how many I was using! So, I just stopped! *He isn’t the one in 24/7 Pain! Talks about how much would go into my system at once. It didn’t seem to matter on Tuesday, July 19, when I accidentally overtook *XCOPRI! 350Mgs. worth in one day! This includes everything else I take. I “slept it off.” Got out of bed at 5p.m. and fixed super. *That Was Okay. I am now watching my weekly pill containers more carefully. And I count what I take beforehand.

    Liked by 1 person

    Comment by Effie Erhardt — July 22, 2022 @ 4:36 PM

  10. My heart breaks for you. Living with Arthur’s pain, like I do, every day.

    Like

    Comment by Phylis Feiner Johnson — July 25, 2022 @ 5:24 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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