Epilepsy and Vagus Nerve Stimulation System

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Epilepsy and Vagus Nerve Stimulation System

• Lincoln High School 2009-2010 In-service
• Rebecca Lam, School District Nurse

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Objectives

• Discuss general information related to seizures
  and epilepsy
• Identify symptoms of a seizure and immediate
  action
• Identify common treatment options
• Discuss purpose and action of VNS system
• Discuss step-by-step instruction of VNS and
  magnet utilization during seizure
• Discuss safety considerations during and after
  seizure

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What is epilepsy?

• Epilepsy- brain disorder in which clusters of
  nerve cells, or neurons, in the brain sometimes
  signal abnormally. In epilepsy, the normal
  pattern of neuronal activity becomes disturbed,
  causing strange sensations, emotions, and
  behavior or sometimes convulsions, muscle spasms,
  and loss of consciousness
• (http//www.ninds.nih.gov/disorders/epilepsy/epile
  psy.htm, 2009)

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Types of Seizures

• Generalized Tonic-Clonic (Grand Mal)- sudden
  rigidity followed by muscle jerks, shallow
  breathing, bluish skin, loss of bladder/bowel
  control
• Absence- blank stare, rapid blinking, repetitive
  chewing, lost of awareness during seizures
• Simple Partial- uncontrollable jerking of one
  area of the body while remaining fully cognizant
• Complex partial- combination of absence and
  simple partial
• Atonic Seizure- sudden collapse but regains
  consciousness within seconds to a minute
• Myoclonic- sudden brief massive muscle jerks
• (Epilepsy Foundation of America, 1995)

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Common Treatment Options

• Medications
• Surgery
• Devices

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Vagus Nerve Stimulator 101

• Battery-operated implant that gets placed along
  the vagus nerve to control seizures for patients
  who have not been responsive to medications
• Device is set by the neurologist to send
  electrical impulses on a regular schedule
• Holding a separate magnet at the implant
  activates the device outside of its regular
  scheduled intervals
• (http//www.epilepsy.com/epilepsy/vns, 2006)

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Magnet Instructions and Safety Considerations

• Magnet is used if
• Student has a sense that a seizure is coming
  (aura)
• During or at the start of a seizure
• Instructions
• Swipe magnet across the generator starting at
  the middle of the chest across the left of the
  chest counting one, one-thousand
• Wait 1-2 minutes, if the seizure continues,
  swipe across again
• Do not continue use of magnet for over 4 hours
  because it can damage the left vagus nerve
• DO NOT hold magnet on the generator for more than
  6 seconds
• because it will cause the stimulator device to
  turn off

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VNS Images
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Other Necessary First Aid for Seizures

• Maintain safe environment
• Cushion head
• Loosen tight neck wear
• Turn patient on side (avoid aspiration)
• DO NOT
• Place any object in students mouth during or
  immediately after seizure
• Hold student down

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After Seizure Care

• Assess student to make sure he/she is breathing
• As he/she gains consciousness, orient him/her to
  place, time, and situation
• Allow student to rest until he/she feels ready to
  return to regular class participation

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Sources

• http//www.epilepsy.com/epilepsy/vns
• http//www.ninds.nih.gov/disorders/epilepsy/detail
  _epilepsy.htm
• http//www.musc.edu/mainpages/features/images/vns.
  jpg