[How I treat ... refractory epilepsy by vagal nerve stimulation]

Intermittent left vagus nerve stimulation is a novel therapeutic modality that can be proposed to patients with a refractory epilepsy and for whom resective surgery is not an option. Its precise mechanism of action is not known. Controlled studies have shown that its efficacy is similar to that of antiepileptic drugs: 50% decrease in seizure frequency in 40% patients after two years. Side effects which are generally mild to moderate are the result of a diffusion of the stimulation to the larynx. No CNS side effect has been reported.