n innovative seizure
control procedure was recently performed on
an adolescent boy with epilepsy at Winthrop.
Mark Mittler, MD, Voluntary Attending, Division of Pediatric Neurosurgery at Winthrop, displays the vagus nerve stimulator (VNS), which can help control seizures in some patients.
The implantation of a vagus nerve stimulator (VNS) had
previously been reserved for adult patients whose seizures could not be successfully
controlled with conventional
anti-convulsant drugs. This patient was the first child at Winthrop to receive the VNS implant.
Vijaya Atluru, MD, Director, Pediatric Neurology Division at Winthrop, and her associates, had referred the patient to Mark Mittler, MD. Dr. Mittler implanted the pacemaker-like device, which contains two wires that are tunneled up to the vagus nerve, a cranial nerve in the neck, next
to the carotid artery.
The device actually consists
of a pair of electrodes, which are carefully wrapped around the delicate vagus nerve. The stimulator is implanted in the underarm, and connected with the vagus nerve electrodes through a tiny wire that runs under the skin.
The patient was instructed to apply a magnet to the top of the device, in the underarm, when experiencing the onset of a seizure. Some patients are alerted to the impending seizure with a visual cue -
a halo of light around people and objects. In very young patients,
parents can apply the magnet when seizure activity is noticed. The touch of the magnet stimulates the nerve in the neck, which often
prevents or controls seizures.
Vijaya Atluru, MD, Director, Pediatric Neurology Division at Winthrop.
Appropriate patients are usually identified by neurologists, and the implantation procedure is performed by a neurosurgeon. Approximately two weeks after the surgery, the device is turned on by a laptop
computer in the neurologist’s office during an outpatient visit.
“Clearly, the vagus nerve stimulator is not appropriate for all patients with seizure disorders,” noted Dr. Mittler. “Winthrop is one of the first hospitals in this region to utilize this new therapy for a youngster.”
Concluded Dr. Atluru, “VNS is not viewed
as ‘better’ than medicine. It works in conjunction with medicine. We expect that with VNS
support, the anti-convulsant medication will be effective in preventing seizures. With the technology in place, many more children can benefit from VNS.”
For additional information, call Dr. Atluru at (516) 663-9494.