Schachter S C, Saper C B
Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
Epilepsia. 1998 Jul;39(7):677-86. doi: 10.1111/j.1528-1157.1998.tb01151.x.
Left vagus nerve stimulation (VNS) is a promising new treatment for epilepsy. In 1997, VNS was approved in the United States as an adjunctive treatment for medically refractory partial-onset seizures in adults and adolescents. For some patients with partial-onset seizures, the adverse effects of antiepileptic drugs (AEDs) are intolerable; for others, no single AED or combination of anticonvulsant agents is effective. Cerebral resective surgery is an option to pharmacotherapy in some cases, but many patients with partial-onset seizures are not optimal candidates for intracranial surgery. VNS entails implantation of a programmable signal generator--the Neuro-cybernetic Prosthesis (NCP)--in the chest cavity. The stimulating electrodes of the NCP carry electrical signals from the generator to the left vagus nerve. Although the mechanism of action of VNS is not known, controlled studies have shown that it is safe and well-tolerated by patients with long-standing partial-onset epilepsy. Side effects, which are generally of mild to moderate severity, almost always disappear after the stimulation settings are adjusted. Encouraging results have also been reported in pediatric patients.
左侧迷走神经刺激（VNS）是一种很有前景的新型癫痫治疗方法。1997年，VNS在美国被批准作为成人和青少年药物难治性部分性发作的辅助治疗方法。对于一些部分性发作的患者来说，抗癫痫药物（AEDs）的不良反应难以耐受；对于另一些患者，单一的AED或抗惊厥药物组合均无效。在某些情况下，脑切除手术是药物治疗的一种选择，但许多部分性发作的患者并非颅内手术的最佳候选者。VNS需要在胸腔内植入一个可编程信号发生器——神经控制假体（NCP）。NCP的刺激电极将电信号从发生器传导至左侧迷走神经。尽管VNS的作用机制尚不清楚，但对照研究表明，长期患有部分性癫痫的患者使用VNS是安全且耐受性良好的。副作用一般为轻至中度，几乎总是在调整刺激设置后消失。儿科患者也报告了令人鼓舞的结果。
