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Why might a child with tuberous sclerosis get vagal nerve stimulation?

Dr. Aria Fallah, MD
Neurosurgeon

A child with tuberous sclerosis (TSC) might get vagal nerve stimulation because not every child with TSC will be a candidate for surgery to treat epilepsy. The seizures may be arising from multiple tubers of the brain or they're starting from the entire brain, or the child may have a generalized epilepsy. In those situations, removing one portion of the brain may not be effective or in an older child, if the tuber is located in a very eloquent area of the brain that carries a lot of function, it may not be safe to remove that part, as that can cause an unwanted neurological deficit.

In those situations, vagal nerve stimulation is a great alternative for these children. This is an implantable device that wraps around one of the main nerves that goes to the brain called the vagus nerve. It's a pacemaker-like device that sits under the skin right over the chest and it generates electrical signals that go through this nerve to the brain. This can cause significant reduction in the number of seizures and also the severity of these seizures. It is a great alternative for children that are not candidates for epilepsy surgery.

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