New procedure to keep epilepsy under control

Patients suffering from a severe form of epilepsy may now be offered a new procedure at the Norfolk and Norwich University Hospital to help reduce the frequency of their seizures.

Known as VNS (vagal nerve stimulation) it works in a similar way to a pacemaker. A small electronic device is implanted below the collarbone and linked by a subcutaneous lead to the left vagus nerve in the neck, sending repeated electronic pulses that help to suppress the brain activity that triggers a seizure.

VNS became available at the Norfolk and Norwich for the first time in December 2006 but is only suitable for a small number of patients. Before that, patients thought to be suitable for the procedure were referred to the National Hospital for Neurology and Neurosurgery in London for assessment and treatment.

“On average, VNS reduces the frequency of seizures by 50 per cent in about 45 per cent of patients, although some patients have reported much more dramatic results,” says consultant neurologist Dr Jeff Cochius .

At NNUH the surgical procedure is carried out by ENT surgeon Mr Paul Montgomery and afterwards the patients return to the hospital several times to have the level of stimulation adjusted. “We start low and increase the intensity over a period of a few months,” explains Dr Cochius.

“Patients also have the option to swipe a magnet over the VNS device to intensify the vagal nerve stimulation and abort a seizure in its early stages. This may give patients a degree of control over their epilepsy that they have never had before.”

One of the first patients to have a VNS device fitted at the Norfolk and Norwich University Hospital is Neil Hatton, 36, from Gorleston, who has noticed a marked improvement in his epilepsy since the device was implanted in February: “I’m sleeping much better and I’m a lot more wide awake during the day,” he commented.