Vagus nerve stimulation
Vagus nerve stimulation
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DOI：
10.1111/j.1528-1157.1998.tb01151.x
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发表时间：
1998-07-01
期刊：
影响因子：
5.6
通讯作者：
Saper, CB
中科院分区：
文献类型：
--
作者：
Schachter, SC;Saper, CB
左迷走神经刺激（VNS）是一种很有前途的治疗癫痫的新方法。1997年，VNS在美国被批准作为成人和青少年医学难治性部分发作癫痫发作的预防性治疗。对于部分性癫痫发作的患者，抗癫痫药物（AED）的不良反应是无法忍受的;对于其他患者，没有单一的AED或抗惊厥药物的组合是有效的。在某些情况下，脑切除手术是药物治疗的一种选择，但许多部分性癫痫发作的患者并不是颅内手术的最佳人选。迷走神经刺激需要在胸腔内植入一个可编程信号发生器--神经电子假体（NCP）。NCP的刺激电极将电信号从发生器传送到左迷走神经。虽然迷走神经刺激的作用机制尚不清楚，但对照研究表明，长期部分发作癫痫患者对迷走神经刺激安全且耐受良好。副作用通常为轻度至中度，在调整刺激设置后几乎总是消失。在儿科患者中也报告了令人鼓舞的结果。
Left vagus nerve stimulation (VNS) is a promising new treatment for epilepsy. In 1997, VNS was approved in the United States as an adjunctive treatment for medically refractory partial-onset seizures in adults and adolescents. For some patients with partial-onset seizures, the adverse effects of antiepileptic drugs (AEDs) are intolerable; for others, no single AED or combination of anticonvulsant agents is effective. Cerebral resective surgery is an option to pharmacotherapy in some cases, but many patients with partial-onset seizures are not optimal candidates for intracranial surgery. VNS entails implantation of a programmable signal generator-the Neuro-cybemetic Prosthesis (NCP)-in the chest cavity. The stimulating electrodes of the NCP carry electrical signals from the generator to the left vagus nerve. Although the mechanism of action of VNS is not known, controlled studies have shown that it is safe and well-tolerated by patients with long-standing partial-onset epilepsy. Side effects, which are generally of mild to moderate severity, almost always disappear after the stimulation settings are adjusted. Encouraging results have also been reported in pediatric patients.