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Surgically implanted and non‐invasive vagus nerve stimulation: a review of efficacy, safety and tolerability
Author(s) -
BenMenachem E.,
Revesz D.,
Simon B. J.,
Silberstein S.
Publication year - 2015
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12629
Subject(s) - medicine , tolerability , vagus nerve stimulation , vagus nerve , anesthesia , adverse effect , stimulation
Vagus nerve stimulation ( VNS ) is effective in refractory epilepsy and depression and is being investigated in heart failure, headache, gastric motility disorders and asthma. The first VNS device required surgical implantation of electrodes and a stimulator. Adverse events ( AE s) are generally associated with implantation or continuous on−off stimulation. Infection is the most serious implantation‐associated AE . Bradycardia and asystole have also been described during implantation, as has vocal cord paresis, which can last up to 6 months and depends on surgical skill and experience. The most frequent stimulation‐associated AE s include voice alteration, paresthesia, cough, headache, dyspnea, pharyngitis and pain, which may require a decrease in stimulation strength or intermittent or permanent device deactivation. Newer non‐invasive VNS delivery systems do not require surgery and permit patient‐administered stimulation on demand. These non‐invasive VNS systems improve the safety and tolerability of VNS , making it more accessible and facilitating further investigations across a wider range of uses.