What is vagal stimulation

Vagus nerve stimulation

Synonym: vagus stimulation
English: vagus nerve stimulation

1 definition

The Vagus nerve stimulation is a neurological therapy method in which the left vagus nerve is electrically stimulated. It is mainly used for prophylactic epileptic seizures.

2 background

The vagus nerve is the 10th of a total of 12 cranial nerves and the largest nerve of the parasympathetic nerve. It regulates the activity of almost all internal organs and, as the connection between the brain and these organs, represents a point of attack for anticonvulsive therapy. Due to the lack of pain-conducting nerve fibers and a predominant proportion of afferent fibers, the vagus nerve has proven to be a point of attack. In addition, it projects its effect from the nucleus tractus solitarii onto many brain regions.

3 operation

Vagus nerve stimulation differentiates between two methods, invasive and non-invasive (transcutaneous) stimulation.

3.1 Invasive vagus nerve stimulation

The vagus nerve stimulator consists of a battery-operated pulse generator and a cable with electrodes. The stimulation device is implanted below the left clavicle between subcutaneous fatty tissue and the pectoral muscle. From there the cable runs subcutaneously to the neck, where the two electrodes are wrapped around the vagus nerve. The surgical procedure takes place under general anesthesia and takes one to two hours. The battery life is five to ten years and must then be replaced by a small operation.

3.2 Transcutaneous vagus nerve stimulation

In this case, the auricular branch of the vagus nerve is stimulated transcutaneously in the area of ​​the auricle by a special ear electrode.

A non-invasive alternative is a hand-sized device that the patient independently creates and operates at the level of the carotid artery. The vagus is stimulated by generating an electrical field.

4 indication

Vagus nerve stimulation is induced in treatment-resistant or inoperable epilepsy. It is also used in therapy-resistant depression. Areas of application that have not yet been adequately secured are migraines, tinnitus or psychiatric illnesses such as Alzheimer's disease and anxiety disorders.

4.1 Vagus nerve stimulation in epilepsy

The pulse generator sends out electrical impulses every 30 seconds, which are passed on from the vagus nerve to the brain. The electrical impulses inhibit brain activity and reduce epileptic seizures. The stimulation intervals and duration can be individually adjusted by a doctor. In addition, the anticonvulsant effect can be supported by drug treatment.

5 positive side effects

  • Improvement in mood
  • positive influence on wakefulness
  • Improve quality of life

6 side effects