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Vagus nerve stimulation (VNS) therapy update

  • James W. Wheless
    Correspondence
    Corresponding author at: Le Bonheur Children's Hospital, 49 N Dunlap Ave, 3rd Floor FOB, Memphis, TN 38105, United States.
    Affiliations
    Le Bonheur Comprehensive Epilepsy Program, Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States

    Department of Pediatrics, Pediatric Neurology Division, University of Tennessee Health Science Center, Memphis, TN, United States
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  • Andrew J. Gienapp
    Affiliations
    Medical Education, Methodist University Hospital, Memphis, TN, United States

    Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States
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  • Phillippe Ryvlin
    Affiliations
    Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
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      Highlights

      • Criteria to use VNS include: pharmacoresistant seizures, exclusion of non-epileptic events, and ineligibility for epilepsy surgery
      • Studies have demonstrated the efficacy of VNS therapy in adult and pediatric patients with pharmacoresistant epilepsy
      • VNS is safe and generally well tolerated; adverse events are typically related to the surgical procedure or stimulation itself
      • Cost-effectiveness studies indicate that VNS provides a substantial cost-savings benefit to healthcare systems
      • The impact of VNS on mortality and SUDEP remains unsettled, with some data suggesting that it might reduce the risk of SUDEP

      Abstract

      Epilepsy affects millions of people worldwide. Approximately one-third have pharmacoresistant epilepsy, and of these, the majority are not candidates for epilepsy surgery. Vagus nerve stimulation (VNS) therapy has been an option to treat pharmacoresistant seizures for 30 years. In this update, we will review the clinical data that support the device's efficacy in children, adolescents, and adults. We will also review its side-effect profile, quality of life and cost benefits, and the impact the device has on sudden unexpected death in epilepsy (SUDEP). We will then discuss candidate selection and provide guidance on dosing and future models. Vagus nerve stimulation therapy is an effective treatment for many seizure types and epilepsy syndromes with a predictable and benign side-effect profile that supports its role as the most commonly prescribed device to treat pharmacoresistant epilepsy.
      “This article is part of the Supplement issue Neurostimulation for Epilepsy.”

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      References

        • Brodie M.J.
        Road to refractory epilepsy: the Glasgow story.
        Epilepsia. 2013; 54: 5-8
        • Chen Z.
        • Brodie M.J.
        • Liew D.
        • Kwan P.
        Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study.
        JAMA Neurol. 2018; 75: 279-286
        • Schmidt D.
        The clinical impact of new antiepileptic drugs after a decade of use in epilepsy.
        Epilepsy Res. 2002; 50: 21-32
        • Kwan P.
        • Brodie M.J.
        Early identification of refractory epilepsy.
        N Engl J Med. 2000; 342: 314-319
        • Mohanraj R.
        • Brodie M.J.
        Diagnosing refractory epilepsy: response to sequential treatment schedules.
        Eur J Neurol. 2006; 13: 277-282
        • Hitiris N.
        • Mohanraj R.
        • Norrie J.
        • Sills G.J.
        • Brodie M.J.
        Predictors of pharmacoresistant epilepsy.
        Epilepsy Res. 2007; 75: 192-196
        • Jallon P.
        The problem of intractability: the continuing need for new medical therapies in epilepsy.
        Epilepsia. 1997; 38: S37-S42
        • Patsalos P.N.
        • Duncan J.S.
        Antiepileptic drugs. A review of clinically significant drug interactions.
        Drug Saf. 1993; 9: 156-184
        • Pellock J.M.
        • Pippenger C.E.
        Adverse effects of antiepileptic drugs.
        in: Dodson W.E. Pellock J.M. Pediatric epilepsy: diagnosis and therapy. Demos, New York1993: 253-264
        • Schmidt D.
        Adverse effects of antiepileptic drugs.
        Raven Press, New York1982
        • Pellock J.M.
        Antiepileptic drug therapy in the United States: a review of clinical studies and unmet needs.
        Neurology. 1995; 45: S17-S24
        • Kwan P.
        • Brodie M.J.
        Effectiveness of first antiepileptic drug.
        Epilepsia. 2001; 42: 1255-1260
        • Camfield P.
        • Camfield C.
        Acute and chronic toxicity of antiepileptic medications: a selective review.
        Can J Neurol Sci. 1994; 21: S7-11
        • Faught E.
        • Duh M.S.
        • Weiner J.R.
        • Guerin A.
        • Cunnington M.C.
        Nonadherence to antiepileptic drugs and increased mortality: findings from the RANSOM study.
        Neurology. 2008; 71: 1572-1578
        • Wheless J.W.
        • Ashwal S.
        The ketogenic diet.
        in: Swaiman K.F. Ashwal S. Pediatric neurology: principles and practice. CV Mosby Co., Philadelphia, PA1999: 719-728
        • Vining E.P.
        • Freeman J.M.
        • Ballaban-Gil K.
        • Camfield C.S.
        • Camfield P.R.
        • Holmes G.L.
        • et al.
        A multicenter study of the efficacy of the ketogenic diet.
        Arch Neurol. 1998; 55: 1433-1437
        • Epilepsy Foundation
        Epilepsy: a report to the nation.
        Epilepsy Foundation of America, Landover, MD1999
        • Wheless J.W.
        Intractable epilepsy: a survey of patients and caregivers.
        Epilepsy Behav. 2006; 8: 756-764
        • Fisher R.S.
        • Parks-Trusz S.L.
        • Lehman C.
        Social issues in epilepsy.
        in: Shorvon S. Dreifuss F. Fish D. Thomas D. The treatment of epilepsy. Blackwell Science, Cambridge, MA1996: 357-369
        • Schachter S.C.
        • Saper C.B.
        Vagus nerve stimulation.
        Epilepsia. 1998; 39: 677-686
        • LivaNova
        VNS therapy system physician's manual.
        LivaNova, London, UK2018
        • Ben-Menachem E.
        • Manon-Espaillat R.
        • Ristanovic R.
        • Wilder B.J.
        • Stefan H.
        • Mirza W.
        • et al.
        Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. First International Vagus Nerve Stimulation Study Group.
        Epilepsia. 1994; 35: 616-626
        • Handforth A.
        • DeGiorgio C.M.
        • Schachter S.C.
        • Uthman B.M.
        • Naritoku D.K.
        • Tecoma E.S.
        • et al.
        Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial.
        Neurology. 1998; 51: 48-55
        • Ryvlin P.
        • Gilliam F.G.
        • Nguyen D.K.
        • Colicchio G.
        • Iudice A.
        • Tinuper P.
        • et al.
        The long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: the PuLsE (open prospective randomized long-term effectiveness) trial.
        Epilepsia. 2014; 55: 893-900
        • Englot D.J.
        • Hassnain K.H.
        • Rolston J.D.
        • Harward S.C.
        • Sinha S.R.
        • Haglund M.M.
        Quality-of-life metrics with vagus nerve stimulation for epilepsy from provider survey data.
        Epilepsy Behav. 2017; 66: 4-9
        • Kawai K.
        • Tanaka T.
        • Baba H.
        • Bunker M.
        • Ikeda A.
        • Inoue Y.
        • et al.
        Outcome of vagus nerve stimulation for drug-resistant epilepsy: the first three years of a prospective Japanese registry.
        Epileptic Disord. 2017; 19: 327-338
        • Garcia-Pallero M.A.
        • Garcia-Navarrete E.
        • Torres C.V.
        • Pastor J.
        • Navas M.
        • Sola R.G.
        Effectiveness of vagal nerve stimulation in medication-resistant epilepsy. Comparison between patients with and without medication changes.
        Acta Neurochir. 2017; 159: 131-136
        • Hilderink J.
        • Tjepkema-Cloostermans M.C.
        • Geertsema A.
        • Glastra-Zwiers J.
        • de Vos C.C.
        Predicting success of vagus nerve stimulation (VNS) from EEG symmetry.
        Seizure. 2017; 48: 69-73
        • Elliott R.E.
        • Rodgers S.D.
        • Bassani L.
        • Morsi A.
        • Geller E.B.
        • Carlson C.
        • et al.
        Vagus nerve stimulation for children with treatment-resistant epilepsy: a consecutive series of 141 cases.
        J Neurosurg Pediatr. 2011; 7: 491-500
        • Helmers S.L.
        • Wheless J.W.
        • Frost M.
        • Gates J.
        • Levisohn P.
        • Tardo C.
        • et al.
        Vagus nerve stimulation therapy in pediatric patients with refractory epilepsy: retrospective study.
        J Child Neurol. 2001; 16: 843-848
        • Alexopoulos A.V.
        • Kotagal P.
        • Loddenkemper T.
        • Hammel J.
        • Bingaman W.E.
        Long-term results with vagus nerve stimulation in children with pharmacoresistant epilepsy.
        Seizure. 2006; 15: 491-503
        • Benifla M.
        • Rutka J.T.
        • Logan W.
        • Donner E.J.
        Vagal nerve stimulation for refractory epilepsy in children: indications and experience at The Hospital for Sick Children.
        Childs Nerv Syst. 2006; 22: 1018-1026
        • You S.J.
        • Kang H.C.
        • Kim H.D.
        • Ko T.S.
        • Kim D.S.
        • Hwang Y.S.
        • et al.
        Vagus nerve stimulation in intractable childhood epilepsy: a Korean multicenter experience.
        J Korean Med Sci. 2007; 22: 442-445
        • Cersosimo R.O.
        • Bartuluchi M.
        • Fortini S.
        • Soraru A.
        • Pomata H.
        • Caraballo R.H.
        Vagus nerve stimulation: effectiveness and tolerability in 64 paediatric patients with refractory epilepsies.
        Epileptic Disord. 2011; 13: 382-388
        • Connor Jr., D.E.
        • Nixon M.
        • Nanda A.
        • Guthikonda B.
        Vagal nerve stimulation for the treatment of medically refractory epilepsy: a review of the current literature.
        Neurosurg Focus. 2012; 32E12
        • Frost M.
        • Gates J.
        • Helmers S.L.
        • Wheless J.W.
        • Levisohn P.
        • Tardo C.
        • et al.
        Vagus nerve stimulation in children with refractory seizures associated with Lennox–Gastaut syndrome.
        Epilepsia. 2001; 42: 1148-1152
        • Parker A.P.
        • Polkey C.E.
        • Binnie C.D.
        • Madigan C.
        • Ferrie C.D.
        • Robinson R.O.
        Vagal nerve stimulation in epileptic encephalopathies.
        Pediatrics. 1999; 103: 778-782
        • Lundgren J.
        • Amark P.
        • Blennow G.
        • Stromblad L.G.
        • Wallstedt L.
        Vagus nerve stimulation in 16 children with refractory epilepsy.
        Epilepsia. 1998; 39: 809-813
        • Hornig G.W.
        • Murphy J.V.
        • Schallert G.
        • Tilton C.
        Left vagus nerve stimulation in children with refractory epilepsy: an update.
        South Med J. 1997; 90: 484-488
        • Parain D.
        • Penniello M.J.
        • Berquen P.
        • Delangre T.
        • Billard C.
        • Murphy J.V.
        Vagal nerve stimulation in tuberous sclerosis complex patients.
        Pediatr Neurol. 2001; 25: 213-216
        • Parker A.P.
        • Polkey C.E.
        • Robinson R.O.
        Vagal nerve stimulation in the epileptic encephalopathies: 3-year follow-up.
        Pediatrics. 2001; 108: 221
        • Murphy J.V.
        • Wheless J.W.
        • Schmoll C.M.
        Left vagal nerve stimulation in six patients with hypothalamic hamartomas.
        Pediatr Neurol. 2000; 23: 167-168
        • Hosain S.
        • Nikalov B.
        • Harden C.
        • Li M.
        • Fraser R.
        • Labar D.
        Vagus nerve stimulation treatment for Lennox–Gastaut syndrome.
        J Child Neurol. 2000; 15: 509-512
        • Aicardi J.
        Vagal nerve stimulation in epileptic encephalopathies.
        Pediatrics. 1999; 103: 821-822
        • Aldenkamp A.P.
        • Majoie H.J.
        • Berfelo M.W.
        • Evers S.M.
        • Kessels A.G.
        • Renier W.O.
        • et al.
        Long-term effects of 24-month treatment with vagus nerve stimulation on behaviour in children with Lennox–Gastaut syndrome.
        Epilepsy Behav. 2002; 3: 475-479
        • Wilfong A.A.
        • Schultz R.J.
        Vagus nerve stimulation for treatment of epilepsy in Rett syndrome.
        Dev Med Child Neurol. 2006; 48: 683-686
        • Zamponi N.
        • Rychlicki F.
        • Corpaci L.
        • Cesaroni E.
        • Trignani R.
        Vagus nerve stimulation (VNS) is effective in treating catastrophic 1 epilepsy in very young children.
        Neurosurg Rev. 2008; 31: 291-297
        • Rossignol E.
        • Lortie A.
        • Thomas T.
        • Bouthiller A.
        • Scavarda D.
        • Mercier C.
        • et al.
        Vagus nerve stimulation in pediatric epileptic syndromes.
        Seizure. 2009; 18: 34-37
        • Major P.
        • Thiele E.A.
        Vagus nerve stimulation for intractable epilepsy in tuberous sclerosis complex.
        Epilepsy Behav. 2008; 13: 357-360
        • Koenig S.A.
        • Longin E.
        • Bell N.
        • Reinhard J.
        • Gerstner T.
        Vagus nerve stimulation improves severely impaired heart rate variability in a patient with Lennox–Gastaut-Syndrome.
        Seizure. 2008; 17: 469-472
        • You S.J.
        • Kang H.C.
        • Ko T.S.
        • Kim H.D.
        • Yum M.S.
        • Hwang Y.S.
        • et al.
        Comparison of corpus callosotomy and vagus nerve stimulation in children with Lennox–Gastaut syndrome.
        Brain and Development. 2008; 30: 195-199
        • Zamponi N.
        • Passamonti C.
        • Cappanera S.
        • Petrelli C.
        Clinical course of young patients with Dravet syndrome after vagal nerve stimulation.
        Eur J Paediatr Neurol. 2011; 15: 8-14
        • Fulton S.P.
        • Van Poppel K.
        • McGregor A.L.
        • Mudigoudar B.
        • Wheless J.W.
        Vagus nerve stimulation in intractable epilepsy associated with SCN1A gene abnormalities.
        J Child Neurol. 2017; 32: 494-498
        • Dibue-Adjei M.
        • Fischer I.
        • Steiger H.J.
        • Kamp M.A.
        Efficacy of adjunctive vagus nerve stimulation in patients with Dravet syndrome: a meta-analysis of 68 patients.
        Seizure. 2017; 50: 147-152
        • Murphy J.V.
        Left vagal nerve stimulation in children with medically refractory epilepsy. The pediatric VNS study group.
        J Pediatr. 1999; 134: 563-566
        • Hornig G.
        • Murphy J.V.
        Vagal nerve stimulation: updated experience in 60 pediatric patients [abstract].
        in: AES Proceedings, Annual Meeting of the American Epilepsy Society, San Diego, CA, December 6–9, 1998. Epilepsia. vol. 39. 1998: 169
        • Schallert G.
        • Murphy J.
        Vagal nerve stimulation: experience in 60 children [poster abstract].
        Neurology. 1998; 50: 14
        • Murphy J.V.
        • Hornig G.
        • Schallert G.
        Left vagal nerve stimulation in children with refractory epilepsy. Preliminary observations.
        Arch Neurol. 1995; 52: 886-889
        • Park Y.D.
        The effects of vagus nerve stimulation therapy on patients with intractable seizures and either Landau–Kleffner syndrome or autism.
        Epilepsy Behav. 2003; 4: 286-290
        • Gates J.
        • Huf R.
        • Frost M.
        Vagus nerve stimulation for patients in residential treatment facilities.
        Epilepsy Behav. 2001; 2: 563-567
        • Andriola M.R.
        • Vitale S.A.
        Vagus nerve stimulation in the developmentally disabled.
        Epilepsy Behav. 2001; 2: 129-134
        • Winston K.R.
        • Levisohn P.
        • Miller B.R.
        • Freeman J.
        Vagal nerve stimulation for status epilepticus.
        Pediatr Neurosurg. 2001; 34: 190-192
        • Labar D.
        • Murphy J.
        • Tecoma E.
        Vagus nerve stimulation for medication-resistant generalized epilepsy. E04 VNS study group.
        Neurology. 1999; 52: 1510-1512
        • Ng M.
        • Devinsky O.
        Vagus nerve stimulation for refractory idiopathic generalised epilepsy.
        Seizure. 2004; 13: 176-178
        • Holmes M.D.
        • Silbergeld D.L.
        • Drouhard D.
        • Wilensky A.J.
        • Ojemann L.M.
        Effect of vagus nerve stimulation on adults with pharmacoresistant generalized epilepsy syndromes.
        Seizure. 2004; 13: 340-345
        • Nei M.
        • O'Connor M.
        • Liporace J.
        • Sperling M.R.
        Refractory generalized seizures: response to corpus callosotomy and vagal nerve stimulation.
        Epilepsia. 2006; 47: 115-122
        • Kostov H.
        • Larsson P.G.
        • Roste G.K.
        Is vagus nerve stimulation a treatment option for patients with drug-resistant idiopathic generalized epilepsy?.
        Acta Neurol Scand Suppl. 2007; 187: 55-58
        • Labar D.
        • Nikolov B.
        • Tarver B.
        • Fraser R.
        Vagus nerve stimulation for symptomatic generalized epilepsy: a pilot study.
        Epilepsia. 1998; 39: 201-205
        • Englot D.J.
        • Chang E.F.
        • Auguste K.I.
        Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response.
        J Neurosurg. 2011; 115: 1248-1255
        • Arya R.
        • Greiner H.M.
        • Lewis A.
        • Mangano F.T.
        • Gonsalves C.
        • Holland K.D.
        • et al.
        Vagus nerve stimulation for medically refractory absence epilepsy.
        Seizure. 2013; 22: 267-270
        • Englot D.J.
        • Rolston J.D.
        • Wright C.W.
        • Hassnain K.H.
        • Chang E.F.
        Rates and predictors of seizure freedom with vagus nerve stimulation for intractable epilepsy.
        Neurosurgery. 2016; 79: 345-353
        • Koo B.
        • Ham S.D.
        • Sood S.
        • Tarver B.
        Human vagus nerve electrophysiology: a guide to vagus nerve stimulation parameters.
        J Clin Neurophysiol. 2001; 18: 429-433
        • Majoie H.J.
        • Berfelo M.W.
        • Aldenkamp A.P.
        • Evers S.M.
        • Kessels A.G.
        • Renier W.O.
        Vagus nerve stimulation in children with therapy-resistant epilepsy diagnosed as Lennox–Gastaut syndrome: clinical results, neuropsychological effects, and cost-effectiveness.
        J Clin Neurophysiol. 2001; 18: 419-428
        • Crumrine P.K.
        Vagal nerve stimulation in children.
        Semin Pediatr Neurol. 2000; 7: 216-223
        • Heck C.
        • Helmers S.L.
        • DeGiorgio C.M.
        Vagus nerve stimulation therapy, epilepsy, and device parameters: scientific basis and recommendations for use.
        Neurology. 2002; 59: S31-S37
        • Fernando D.A.
        • Lord R.S.
        The blood supply of vagus nerve in the human: its implication in carotid endarterectomy, thyroidectomy and carotid arch aneurectomy.
        Ann Anat. 1994; 176: 333-337
        • Robinson L.C.
        • Winston K.R.
        Relationship of vocal cord paralysis to the coil diameter of vagus nerve stimulator leads.
        J Neurosurg. 2015; 122: 532-535
      1. Neurology. 1995; 45: 224-230
        • Ramsay R.E.
        • Uthman B.M.
        • Augustinsson L.E.
        • Upton A.R.
        • Naritoku D.
        • Willis J.
        • et al.
        Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. First International Vagus Nerve Stimulation Study Group.
        Epilepsia. 1994; 35: 627-636
        • Liporace J.
        • Hucko D.
        • Morrow R.
        • Barolat G.
        • Nei M.
        • Schnur J.
        • et al.
        Vagal nerve stimulation: adjustments to reduce painful side effects.
        Neurology. 2001; 57: 885-886
        • Lundgren J.
        • Ekberg O.
        • Olsson R.
        Aspiration: a potential complication to vagus nerve stimulation.
        Epilepsia. 1998; 39: 998-1000
        • Schallert G.
        • Foster J.
        • Lindquist N.
        • Murphy J.V.
        Chronic stimulation of the left vagal nerve in children: effect on swallowing.
        Epilepsia. 1998; 39: 1113-1114
        • Zambrelli E.
        • Saibene A.M.
        • Furia F.
        • Chiesa V.
        • Vignoli A.
        • Pipolo C.
        • et al.
        Laryngeal motility alteration: a missing link between sleep apnea and vagus nerve stimulation for epilepsy.
        Epilepsia. 2016; 57: e24-e27
        • Salvade A.
        • Ryvlin P.
        • Rossetti A.O.
        Impact of vagus nerve stimulation on sleep-related breathing disorders in adults with epilepsy.
        Epilepsy Behav. 2018; 79: 126-129
        • Ryvlin P.
        • So E.L.
        • Gordon C.M.
        • Hesdorffer D.C.
        • Sperling M.R.
        • Devinsky O.
        • et al.
        Long-term surveillance of SUDEP in drug-resistant epilepsy patients treated with VNS therapy.
        Epilepsia. 2018; 59: 562-572
        • Annegers J.F.
        • Coan S.P.
        • Hauser W.A.
        • Leestma J.
        Epilepsy, vagal nerve stimulation by the NCP system, all-cause mortality, and sudden, unexpected, unexplained death.
        Epilepsia. 2000; 41: 549-553
        • Granbichler C.A.
        • Nashef L.
        • Selway R.
        • Polkey C.E.
        Mortality and SUDEP in epilepsy patients treated with vagus nerve stimulation.
        Epilepsia. 2015; 56: 291-296
        • Graves N.
        Anticonvulsants: choices and costs.
        Am J Manag Care. 1998; 4: S463-S464
        • Ben-Menachem E.
        • Hellstrom K.
        • Verstappen D.
        Analysis of direct hospital costs before and 18 months after treatment with vagus nerve stimulation therapy in 43 patients.
        Neurology. 2002; 59: S44-S47
        • Boon P.
        • D'Have M.
        • Van Walleghem P.
        • Michielsen G.
        • Vonck K.
        • Caemaert J.
        • et al.
        Direct medical costs of refractory epilepsy incurred by three different treatment modalities: a prospective assessment.
        Epilepsia. 2002; 43: 96-102
        • Bernstein A.L.
        • Hess T.
        Vagus nerve stimulation therapy for pharmacoresistant epilepsy: effect on healthcare utilization.
        Epilepsy Behav. 2007; 10: 134-137
        • Helmers S.L.
        • Griesemer D.A.
        • Dean J.C.
        • Sanchez J.D.
        • Labar D.
        • Murphy J.V.
        • et al.
        Observations on the use of vagus nerve stimulation earlier in the course of pharmacoresistant epilepsy: patients with seizures for six years or less.
        Neurologist. 2003; 9: 160-164
        • Labar D.R.
        Antiepileptic drug use during the first 12 months of vagus nerve stimulation therapy: a registry study.
        Neurology. 2002; 59: S38-S43
        • Englot D.J.
        • Rolston J.D.
        • Wang D.D.
        • Hassnain K.H.
        • Gordon C.M.
        • Chang E.F.
        Efficacy of vagus nerve stimulation in posttraumatic versus nontraumatic epilepsy.
        J Neurosurg. 2012; 117: 970-977
        • Morris III, G.L.
        • Gloss D.
        • Buchhalter J.
        • Mack K.J.
        • Nickels K.
        • Harden C.
        Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy: report of the Guideline Development Subcommittee of the American Academy of Neurology.
        Neurology. 2013; 81: 1453-1459
        • Van Ness P.C.
        Surgical outcome for neocortical (extrahippocampal) focal epilepsy.
        in: Luders H.O. Epilepsy surgery. Raven Press, New York1992: 213-624
        • Sperling M.R.
        • O'Connor M.J.
        • Saykin A.J.
        • Plummer C.
        Temporal lobectomy for refractory epilepsy.
        JAMA. 1996; 276: 470-475
        • Fisher R.S.
        • Handforth A.
        Reassessment: vagus nerve stimulation for epilepsy: a report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.
        Neurology. 1999; 53: 666-669
        • Baumgartner J.E.
        • Clifton G.L.
        • Wheless J.W.
        • Willmore L.J.
        • Brookshire B.L.
        • Sorenson J.M.
        Corpus callosotomy.
        Oper Tech Neurosurg. 1995; 1: 45-51
        • Camfield P.R.
        • Camfield C.S.
        Vagal nerve stimulation for treatment of children with epilepsy.
        J Pediatr. 1999; 134: 532-533
        • Lancman G.
        • Virk M.
        • Shao H.
        • Mazumdar M.
        • Greenfield J.P.
        • Weinstein S.
        • et al.
        Vagus nerve stimulation vs. corpus callosotomy in the treatment of Lennox–Gastaut syndrome: a meta-analysis.
        Seizure. 2013; 22: 3-8
        • Sorenson J.M.
        • Wheless J.W.
        • Baumgartner J.E.
        • Thomas A.B.
        • Brookshire B.L.
        • Clifton G.L.
        • et al.
        Corpus callosotomy for medically intractable seizures.
        Pediatr Neurosurg. 1997; 27: 260-267
        • Schwartz T.H.
        • Spencer D.D.
        Strategies for reoperation after comprehensive epilepsy surgery.
        J Neurosurg. 2001; 95: 615-623
        • Amar A.P.
        • Apuzzo M.L.
        • Liu C.Y.
        Vagus nerve stimulation therapy after failed cranial surgery for intractable epilepsy: results from the vagus nerve stimulation therapy patient outcome registry.
        Neurosurgery. 2004; 55: 1086-1093
        • Elliott R.E.
        • Morsi A.
        • Geller E.B.
        • Carlson C.C.
        • Devinsky O.
        • Doyle W.K.
        Impact of failed intracranial epilepsy surgery on the effectiveness of subsequent vagus nerve stimulation.
        Neurosurgery. 2011; 69: 1210-1217
        • Renfroe J.B.
        • Wheless J.W.
        Earlier use of adjunctive vagus nerve stimulation therapy for refractory epilepsy.
        Neurology. 2002; 59: S26-S30
        • Scherrmann J.
        • Hoppe C.
        • Kral T.
        • Schramm J.
        • Elger C.E.
        Vagus nerve stimulation: clinical experience in a large patient series.
        J Clin Neurophysiol. 2001; 18: 408-414
        • Helmers S.L.
        • Duh M.S.
        • Guerin A.
        • Sarda S.P.
        • Samuelson T.M.
        • Bunker M.T.
        • et al.
        Clinical and economic impact of vagus nerve stimulation therapy in patients with drug-resistant epilepsy.
        Epilepsy Behav. 2011; 22: 370-375
        • Helmers S.L.
        • Duh M.S.
        • Guerin A.
        • Sarda S.P.
        • Samuelson T.M.
        • Bunker M.T.
        • et al.
        Clinical outcomes, quality of life, and costs associated with implantation of vagus nerve stimulation therapy in pediatric patients with drug-resistant epilepsy.
        Eur J Paediatr Neurol. 2012; 16: 449-458
        • Kwan P.
        • Arzimanoglou A.
        • Berg A.T.
        • Brodie M.J.
        • Allen Hauser W.
        • Mathern G.
        • et al.
        Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies.
        Epilepsia. 2010; 51: 1069-1077
        • Eggleston K.S.
        • Olin B.D.
        • Fisher R.S.
        Ictal tachycardia: the head–heart connection.
        Seizure. 2014; 23: 496-505
        • Hirsch M.
        • Altenmuller D.M.
        • Schulze-Bonhage A.
        Latencies from intracranial seizure onset to ictal tachycardia: a comparison to surface EEG patterns and other clinical signs.
        Epilepsia. 2015; 56: 1639-1647
        • Fisher R.S.
        • Eggleston K.S.
        • Wright C.W.
        Vagus nerve stimulation magnet activation for seizures: a critical review.
        Acta Neurol Scand. 2015; 131: 1-8
        • Schneider U.C.
        • Bohlmann K.
        • Vajkoczy P.
        • Straub H.B.
        Implantation of a new vagus nerve stimulation (VNS) therapy(R) generator, AspireSR(R): considerations and recommendations during implantation and replacement surgery—comparison to a traditional system.
        Acta Neurochir. 2015; 157: 721-728
        • Fisher R.S.
        • Afra P.
        • Macken M.
        • Minecan D.N.
        • Bagic A.
        • Benbadis S.R.
        • et al.
        Automatic vagus nerve stimulation triggered by ictal tachycardia: clinical outcomes and device performance—the U.S. E-37 trial.
        Neuromodulation. 2016; 19: 188-195
        • Hampel K.G.
        • Vatter H.
        • Elger C.E.
        • Surges R.
        Cardiac-based vagus nerve stimulation reduced seizure duration in a patient with refractory epilepsy.
        Seizure. 2015; 26: 81-85
        • Boon P.
        • Vonck K.
        • van Rijckevorsel K.
        • El Tahry R.
        • Elger C.E.
        • Mullatti N.
        • et al.
        A prospective, multicenter study of cardiac-based seizure detection to activate vagus nerve stimulation.
        Seizure. 2015; 32: 52-61