Brain-type natriuretic peptide release and seizure activity during vagal nerve stimulation

Vagus nerve stimulation (VNS) has emerged as an effective adjunctive therapy for medically refractory epilepsy when surgery is inadvisable. N-terminal brain-type natriuretic peptide (NT-proBNP) is a potent natriuretic, diuretic, and vasodilatative compound first discovered in the human brain but mainly synthesized in the myocardium. The monitoring of VNS effectiveness in reducing seizure frequency or the detection of possible cardiac adverse effects would be helped by a reliable biochemical marker, which has not been available thus far. We report a four-year-old boy with drug-resistant idiopathic generalized epilepsy whose NT-proBNP levels increased during VNS and seizures.