Abstracts

Vagus nerve stimulation (VNS) therapy is the first device-based treatment option for both epilepsy and depression. On the basis of pre-clinical trials, the manufacturer of the VNS Therapy System (Cyberonics, Inc; Houston, TX) recommends that stimulation be started 2 weeks after the device is implanted to allow for surgical recovery time. We intend to show that stimulation activation in the operating room immediately after implantation is safe and well tolerated in children and adolescents regardless of output current, pulse width, and frequency., A retrospective chart analysis was performed on 104 patients aged 8 months to 20 years (median age 7.9 years) with pharmacoresistant epilepsy and implanted with the VNS therapy device between 2001 and mid-2005. All devices were activated intraoperatively. Forty-nine devices were activated using the following stimulation parameters: output current of 0.25 mA, pulse width of 500 [micro]sec, and frequency of 30 Hz. Fifty-five devices were activated using the following parameters: output current of 0.25 mA, pulse width of 250 [micro]sec, and frequency of 20 Hz. All devices were set to a duty cycle of 5 minutes Off and 30 seconds On., All patients tolerated intraoperative VNS activation. Adverse changes in blood pressure, pulse rate, or electrocardiogram (EKG) did not occur at the time of activation or thereafter. No unexpected side effects were reported acutely., Intraoperative activation of the VNS therapy device appears to be safe and well tolerated in children and adolescents regardless of output current, pulse width, and frequency.,