Vagal Nerve Stimulator

The vagus nerve runs from the base of the brain down the neck and into a child’s chest.  There is a nerve located on each side of the body.  A Vagal nerve stimulator or VNS is an implantable device that produces electrical signals to the left vagus nerve that travels into the brain.  These electrical signals will often result in fewer seizures and may reduce the duration and intensity of the seizures as well.  

What to expect during your office visit:

If you or your child experiences seizures you are likely in the care of a Neurologist.  If your Neurologist feels that you may benefit from a VNS device they will often refer you to one of our Neurosurgeons who will discuss the procedure and device with your family in our office. 

There is no imaging or diagnostic tests required in advance of placing a VNS so this visit will primarily be to get to know your child and allow caregivers and to ask questions and learn more about the device and procedure.  

What to expect from surgery:

If you feel your child would benefit from a VNS device this is what to expect at the time of surgery.    Families will be given a date and time during their clinic appointment.  It is standard that children do not have anything to eat past midnight on the day of surgery.  We understand this is difficult for our very young patients and take special care to schedule those surgeries as early in the day as possible.  It is important you bathe your child and wash their hair either the night before or the morning of surgery to help prevent post operative infections.

In the morning your surgeon will review everything discussed in the office and be sure to answer any questions caregivers or children have.  The surgery generally requires 1 hour to complete, and once the surgery is over your Neurosurgeon will come and discuss it with you directly.  Children will then be taken to the recovery area (PACU) and you will be able to join them there.  They will be monitored as the effects of anesthesia wear off.   

Insertion of a VNS device is considered an out patient procedure which means no overnight stay in the hospital will be required.  The device itself is flat and about the size of a golf ball.  It is placed under the skin just below the left collar bone.  Patients often complain of a small amount of pain for a day or two that may require Tylenol or Motrin.  The stitches are internal and dissolvable and small steri strips or butterfly bandages will be place over top.  These are intended to get wet and can be washed with warm and soapy water the day after surgery.  These will often fall off in 7-10 days and no further covering is required.  

To care for the incision wash daily with a mild soap and dry gently.  Patients should avoid submerging the incision completely underwater for 14 days following surgery, so this means taking modified baths and no swimming in pools or lakes.

Caregivers and patients should monitor for any redness or swelling that occurs in the days or weeks following surgery.  Rarely a superficial wound infection could occur and is easily treatable if detected early.  Please notify the Neurosurgery department at (313)833-4490 of any redness, swelling, or drainage and one of Advance Practice Providers will provide you immediate guidance, and a same day appointment if necessary.  

A scheduled “wound check” appointment will be made 10-14 days after surgery with one of our Advanced Practice Providers.  This is a good time to talk about returning to school, day care, or other activities.  This is another great opportunity to sit and answer any and all questions now that the stress of the hospital is behind you.