Oliveira Tatiana Von Hertwig Fernandes de, Francisco Alexandre Novicki, Demartini Zeferino, Stebel Sergio Leandro
Universidade Tecnológica Federal do Paraná, Programa de Pós-Graduação em Engenharia Biomédica, Curitiba PR, Brasil.
Pontifícia Universidade Católica do Paraná, Hospital Universitário Cajuru, Curitiba PR, Brasil.
Arq Neuropsiquiatr. 2017 Sep;75(9):657-666. doi: 10.1590/0004-282X20170113.
Vagus nerve stimulation is an adjunctive therapy used to treat patients with refractory epilepsy who are not candidates for resective surgery or had poor results after surgical procedures. Its mechanism of action is not yet fully comprehended but it possibly involves modulation of the locus coeruleus, thalamus and limbic circuit through noradrenergic and serotonergic projections. There is sufficient evidence to support its use in patients with focal epilepsy and other seizure types. However, it should be recognized that improvement is not immediate and increases over time. The majority of adverse events is stimulation-related, temporary and decreases after adjustment of settings. Future perspectives to improve efficacy and reduce side effects, such as different approaches to increase battery life, transcutaneous stimulation and identification of prognostic factors, should be further investigated.
迷走神经刺激术是一种辅助治疗方法，用于治疗那些不适合进行切除性手术或手术后效果不佳的难治性癫痫患者。其作用机制尚未完全明了，但可能涉及通过去甲肾上腺素能和5-羟色胺能投射对蓝斑、丘脑和边缘系统进行调节。有充分证据支持其用于局灶性癫痫和其他发作类型的患者。然而，应该认识到，改善并非立竿见影，而是随着时间推移而增加。大多数不良事件与刺激相关，是暂时的，在调整参数后会减少。未来提高疗效和减少副作用的前景，如延长电池寿命的不同方法、经皮刺激以及确定预后因素等，应进一步研究。
