Vagal Nerve Stimulator Service

What is VNS therapy?

Vagal Nerve Stimulator (VNS) is an electronic device, consisting of a generator and lead. The generator is implanted under the skin of the chest, the lead is connected to the vagus nerve. VNS therapy is delivered by the generator which is programmed to send mild electrical pulses through the wire to the vagus nerve and to areas of the brain associated with seizure. The aim is to reduce frequency and severity of seizures. 

 

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Why have VNS?

You may be considering having a vagal nerve stimulator (VNS) if you have tried several seizure medications and are still having seizures or unacceptable side effects. It may also be an option if epilepsy surgery is not appropriate for you.

The VNS Service at The Walton Centre

The VNS service provides information and support for you and anyone you feel is important to you and your epilepsy, when considering having a VNS stimulator device implanted. There are dedicated outpatient Vagal Nerve Stimulator Nurse led clinics for check-ups, reviews, programming, and support after surgery.

Before surgery

If you and your consultant feel that a VNS device is appropriate, you will be offered an appointment with an epilepsy nurse specialist. The appointment offers the opportunity to discuss the VNS in more detail, have your questions answered, and receive written information and leaflets. We have provided a link to sources of further information in this leaflet.

Pre-op assessment

At The Walton Centre we have a specialist pre-operative team to assess patients undergoing surgery. The aim is to make sure you are fit enough to go ahead with your planned surgery and anaesthetic. Once you have been listed for surgery you will be asked to complete an online Pre-Operative Assessment Questionnaire. If you are unable to do this online, you will be invited into the hospital to complete it. The pre-op team will then arrange to see you in clinic if needed, or for further investigations (such as bloods or ecg) to be done. And give you instruction for the day of your admission.

After surgery

Once you have the device implanted, the epilepsy nurses will review you on the ward before you are discharged. Here the device can be turned on.

A plan is then agreed to gradually increase the settings over several weeks. This allows you to get used to the device and stimulations over time. The newest technology means programming can be scheduled across 6-12 weeks, to reduce the number of journeys you need to make back to hospital.

Wound care

After surgery you should try to keep your surgical dressing clean, dry and intact for 7-10 days. You can usually shower and wash your hair after 48 hours, take care not to get the area wet. Use a mild shampoo and soap, take care not to rub the wound, and gently pat the area dry.

Sutures (stitches) are usually dissolvable and will not need to be removed. This will be clarified for you by ward staff before you go home. They can tell you if your stitches need to be removed or when a wound check is needed, and who will do it. It can usually be done locally at your GP surgery, walk in centre or by district nurse, depending on services in your area, alternatively you may be asked to attend The Walton Centre.

If your wound or surrounding area becomes red, sore, swollen or leaks pus you need to contact the ward you were discharged from, and let the VNS team know.

Post-surgery and follow-up

An appointment will be made in the VNS outpatient clinic, for review and to offer support after surgery.

The first follow-up after surgery is to review your progress and experience of living with the VNS device. The VNS settings will be reviewed, and initial plan for three monthly visits is agreed to reach your desired and tolerated settings.

Once you are established on an effective setting of the VNS, you will continue to be reviewed every 6-12 months, depending upon your individual needs.

If you have any problems or questions about your VNS device we can be contacted via our secretaries, contact details at the end of this leaflet.

You can also contact our non-urgent epilepsy nurse advice line, details below, for a telephone appointment with one of the epilepsy nurse specialist team.

Once you have had the VNS implanted you will be given a card with numbers to contact in case of an emergency.

Do I still need to take my epilepsy medication?

Yes, it is very important you should continue to take your usual epilepsy medication. VNS is designed to use with epilepsy medications and not to replace them.

Some patients can reduce the amount of epilepsy medication they take over time, but this should only be done under guidance from your medical team and consultant.

What else do I need to know about VNS therapy?

You will be provided with a VNS Therapy ID card, this explains you have a medical device implanted.

If you need to undergo any medical investigations, you should always let medical staff know you have a VNS.

If you need to undergo MRI you should make staff aware of your VNS device, extra precautions and equipment will be needed.

Airport scanners should not interfere with the VNS however you can show staff the VNS ID card and request a pat down check instead.

 

The VNS Team

Neurosurgeons

Mr J. O. Farah

Secretary: Louise Cross 0151 556 3351

Ms D. Bhargava

Secretary: Tina Hughes 0151 556 3350

Epilepsy Specialist Nurses

Nurses involved in care of VNS patients:

Hannah Cowley – Epilepsy Nurse Specialist

Jan McGee - Epilepsy Nurse Specialist

Carole Hewitt – Epilepsy Nurse Specialist

Additional VNS patient support offered by:

Dr Janine Winterbottom – Lead Epilepsy Nurse

Gillian Hart – Epilepsy Nurse Specialist

Monika Czech – Epilepsy Nurse Specialist

 

Epilepsy Nurse Advice Line: 0151 556 4008 (Mon-Fri 9am-4pm, excluding bank holidays)

Epilepsy Nurse Secretary: 0151 556 3525/3537

 

For further information:

Epilepsy Action: www.epilepsy.org.uk 

Epilepsy Society : www.epilepsysociety.org.uk

Liva Nova : www.vnstherapy.com

 

For practical advice our Patient Experience Team can be of assistance. Contact Patient Experience Team on 0151 556 3090 or email: wcft.patientexperienceteam@nhs.net 

www.thewaltoncentre.nhs.uk 

Alternatively, go to www.thebraincharity.org.uk or call 0151 298 2999 for advice and information for people with neurological conditions and their carers