Vagus nerve stimulation in the treatment of epilepsy
Alan Guberman
Division of Neurology, The Ottawa Hospital Ottawa, Ont.

Despite the fact that 15 different antiepileptic drugs are now available for use in Canada, about one-third of patients with epilepsy continue to have inadequate seizure control. Patients with pharmacoresistant epilepsy often experience various side effects of drug therapy, and the failure to control seizures can have devastating psychosocial, economic and health consequences, including serious accidents and cognitive or behavioural deterioration. In a small proportion of patients the effects of the epilepsy are so severe as to warrant brain surgery (usually of the temporal lobe). Innovative approaches have therefore been sought, including the ketogenic diet for children, implanted deep-brain stimulators (under study) and vagus nerve stimulation (VNS), which was approved in the US and Canada in 1997.

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