Treatment of Medically Refractory Epilepsy: A Review Of Vagus Nerve Stimulator

Epilepsy is among the most common disorder encountered by neurologists in their day-to-day practice. While the majority of seizures can be readily controlled with antiepileptic drug (AED) therapy, there remains a small subset of patients who are refractory to AEDs. In these patients even polytherapy with three or more frontline AEDs does not achieve adequate seizure control. In the past the medical community had little to offer these medically intractable epilepsy patients whose quality of life was severely affected by ongoing chronic seizures. In the last decade nonpharmacological treatment options of vagus nerve stimulation (VNS) and responsive neurostimulation (RNS) have provided new ammunition in the fight against epilepsy. These options for medically refractory epilepsy shall be discussed in this article.