Results of intermittent stimulation of the vagus nerve in four patients with intractable partial seizures are reported from the Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC. The criteria for implantation of the device were 1) refractory partial seizures, 2) adequate trials of anti-epileptic drugs, 3) adequate trials of investigational drugs, 4) age 18 to 55 and 5) not a candidate for epilepsy brain surgery. The stimulation electrodes are placed around the vagus nerve at or above the omohyoid muscle. The leads are tunneled through to a subcutaneous pocket in the subclavicular region and connected to the pulse generator. Complex and simple partial seizures as well as secondarily generalized seizures were reduced by 100% in patients 1 and 2 and by 40% in patient 4. Side effects were transient and occurred concomitantly with stimulation and included hoarseness and a stimulation sensation in the neck. One patient had an episode of uncontrolled hiccups. [1]

COMMENT. Five patients age 20 to 59 with complex partial seizures received vagus nerve stimulation at the Neurology Service and Neurological Surgery Section, Department of Veteran’s Affairs Medical Center, Gainesville, Florida [2]. Three patients had a greater than 50% reduction in seizure frequency. The battery life of the stimulator is approximately two years and cost of replacement is comparable to that of a five year supply of anti-epileptic drugs. Vagal stimulation may offer an option of treatment before temporal lobectomy and in patients with bilateral independent epileptogenic foci.