Our services | Vagus nerve stimulation | Programming the vagus nerve stimulator
Programming the vagus nerve stimulator
Following the implantation of the vagus nerve stimulation electrode and pulse generator, the patient is discharged and given an appointment to attend the neurostimulator clinic at the Royal London Hospital approximately 2 weeks later.
At this appointment, the stimulator is programmed to increase stimulator strength. This involves holding a wand on the skin overlying the implanted pulse generator battery to enable remote communication between the implanted pulse generator and our hand held computer.
When programming increases stimulation strength, the patient may experience slight discomfort, usually hoarseness of the voice and some coughing (because the vagus nerve normally controls speech activity). This is usually temporary and passes within 24 to 48 hours. We do not turn the stimulator up to an effective level for seizure control immediately but instead in small increments every two weeks over a few months, allowing the patient gradually to get used to increasing stimulation strengths. Around eight appointments may be required over this period.
Every patient is different and requires different levels of stimulation to achieve seizure control. We monitor the seizures on every patient to determine the most effective level of stimulation that does not result in ongoing intolerable hoarseness or throat tightness during stimulation bursts.
Magnet setting
In addition to background stimulation to reduce ongoing seizures, the vagus nerve stimulator has an additional mode or setting, named the magnet setting.
This setting, which is activated by the patient or relative swiping a magnet across the skin overlying the implanted battery unit, enables the patient to receive a boost of stimulation for up to 60 seconds.
This may be especially beneficial to the patient if he or she experiences warnings prior to their attacks. The additional stimulation applied just before or during an attack may stop the attack occurring or reduce its intensity.
