Abstract
Vagal nerve stimulation is a neurosurgical treatment modality approved for the management of drug-resistant epilepsy. With its increased utilisation, anaesthesiologists will more frequently encounter patients with an indwelling vagal nerve stimulator (VNS), both in the elective and in the emergency surgical settings. Knowledge of the implications of the indwelling VNS in the perioperative period is vitally important for the anaesthesiologist, both for patient safety and to ensure proper device functioning after any intervention.
Highlights
Vagal nerve stimulation is an important treatment modality which is used as an adjunct in the management for drug-resistant epilepsy (DRE) in Ireland
One in three patients has a poor response to anti-epileptic drugs (AED) from the outset of medical management [3]
In 2004, Ali, et al looked at three cases of ventricular asystole with complete heart block that occurred during intraoperative lead tests, to identify the specific type of cardiac abnormality associated with vagus nerve stimulation, and to identify individuals at risk [26]
Summary
Vagal nerve stimulation is an important treatment modality which is used as an adjunct in the management for drug-resistant epilepsy (DRE) in Ireland. Current information suggests that VNS therapy activates neuronal networks in the thalamus and other limbic structures and that noradrenaline may mediate the anti-seizure activity of vagal nerve stimulation. Et al published a case report in 1999 of a 56-year-old man who developed two episodes of bradycardia and transient asystole during routine lead testing during a planned VNS implantation.
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