Fisher Breanne, DesMarteau Julie A, Koontz Elizabeth H, Wilks Seth J, Melamed Susan E
Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Department of Neurosciences, Medical University of South Carolina, Charleston, SC, United States.
Front Neurol. 2021 Jan 15;11:610379. doi: 10.3389/fneur.2020.610379. eCollection 2020.
Vagus nerve stimulation (VNS) is a safe and effective therapy that has been available for over 20 years for adults and children with drug resistant epilepsy (DRE). Since U.S. Food and Drug Administration approval in 1997, VNS has been implanted in over 100,000 patients including over 30,000 children as an adjunctive therapy in reducing the frequency of seizures in patients 4 years of age and older with focal seizures that are refractory to antiseizure medications. VNS Therapy® has evolved over time and currently offers closed-loop, responsive stimulation as well as advanced features that streamline dosing and patient management. Advanced Practice Providers (APPs) such as nurse practitioners, physician assistants and clinical nurse specialists are integral in a comprehensive healthcare team, and dedicated VNS clinics have formed at comprehensive epilepsy centers across the world that are often managed by APPs. This approach improves access, education, and continuity of care for those with VNS or those considering VNS. Here we provide a review for APPs on the VNS Therapy® system focused on new features, dosing, and troubleshooting strategies with the goal to provide guidance to those managing VNS patients.
迷走神经刺激术(VNS)是一种安全有效的治疗方法,已应用于耐药性癫痫(DRE)的成人和儿童患者超过20年。自1997年获得美国食品药品监督管理局批准以来,VNS已植入超过100,000名患者体内,其中包括30,000多名儿童,作为一种辅助治疗手段,用于减少4岁及以上局灶性癫痫发作且对抗癫痫药物难治的患者的癫痫发作频率。随着时间的推移,VNS疗法®不断发展,目前提供闭环、响应式刺激以及简化给药和患者管理的先进功能。高级执业提供者(APPs),如执业护士、医师助理和临床护理专家,是综合医疗团队的重要组成部分,世界各地的综合癫痫中心都设立了专门的VNS诊所,这些诊所通常由APPs管理。这种方法改善了VNS患者或考虑使用VNS的患者的就医机会、教育和护理连续性。在此,我们为APPs提供一篇关于VNS疗法®系统的综述,重点介绍新功能、给药方法和故障排除策略,旨在为管理VNS患者的人员提供指导。
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