The tolerance and efficacy of periodic left vagal nerve (VN) stimulation in 12 children with medically intractable epilepsies are reported from the Sections of Neurology and Neurosurgery, Children’s Mercy Hospital, Kansas City, MO. At 2 to 14 months follow-up, 5 patients had a better than 90% reduction in number of monthly seizures, and the overall status of the child was improved on global evaluation ratings. Antiepileptic drugs were reduced after VN stimulation in 4 patients. No serious adverse effects were noted. Several patients experienced transient coughing with initial activation of the stimulator, and some had vocal hoarseness. Credit card inactivation occurs when the activating magnet is stored in the same pocket with the card. The therapeutic response to VNS appeared to be superior and was achieved more rapidly in children than in adults. 
COMMENT. The advantages of vagal nerve stimulation compared to AEDs in children with refractory seizures were listed as follows: 1) no deterioration of response, 2) no allergic rashes, 3) no cognitive deficits, 4) no drug interactions, and 5) complete compliance. The device was well tolerated and free of serious complications. See Progress in Pediatric Neurology II, 1994, pp132-3, for further reports on vagal nerve stimulation for control of epilepsy.