ABSTRACT
Vagal nerve stimulation (VNS) is US Food and Drug Administration approved for the treatment of medically intractable partial onset epilepsy in patients over 12 years of age. Efficacy and safety issues have been addressed in several large clinical trials and will not be discussed here. Indications for VNS include patients with medically intractable partial epilepsy without resective surgical options or those where surgery is contraindi-cated for medical reasons. Patients with epilepsy uncontrolled by anticonvulsant medications may be candidates for VNS. The patients are then presented at a multidisciplinary epilepsy conference and the decision to implant a VNS is discussed. The use of these magnets is uncomplicated and should be explained to the patient and family members. After pre-operative antibiotics are given, the neck and chest is prepped with Betadine scrub and paint solutions. The platysma muscle is divided in the direction of its fibers and the deep cervical fascia is opened to identify the sternocleidomastoid muscle.
