Vagus Nerve Stimulation Therapy: An Intellectual Disabilities Perspective

Vagus nerve stimulation (VNS) therapy for the treatment of intractable epilepsy is a relatively new form of treatment. However, not all persons with epilepsy are suitable for VNS therapy. Suitability for the procedure is determined by type of seizure disorder, previous response to anticonvulsant medication, health status, compliance with day-to-day use, and the likely benefits to quality of life. Vagus nerve stimulation therapy should be recommended after the failure of three or four adequate trials of anticonvulsant drugs in persons with diagnosed partial or generalized epilepsy. A number of research studies have now been published demonstrating efficacy both in the nonintellectually disabled population and in persons with intellectual disabilities. It has comparable efficacy to new antiepileptic drugs, is safe, well tolerated, and manageable. The rate of adverse effects of VNS therapy are comparable to those with pharmaceutical treatments and relate to surgical implantation of the device, stimulation-related, and serious adverse events such as bradycardia or asystole. Further multicenter research specifically in persons with intellectual disabilities is recommended.