Vagus nerve stimulation and the ketogenic diet

James Wheless, James Baumgartner, Caroline Ghanbari

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

There is increasing recognition that patients who fail treatment with AED therapy may benefit from other treatment modalities. Other established treatment modalities include traditional epilepsy surgery, VNS, and the KD. In the patient who has failed to respond to appropriate treatment with at least three AEDs, preferably with different mechanisms of actions, VNS offers significant hope for improvement in seizure control and QOL. The combination of VNS and AED therapy allows the patient to be on polytherapy, without experiencing the side effects of a polypharmacy. VNS therapy is unique. It allows the physician to achieve the desired goals of improved seizure control and treatment with a different mechanism of action, without concerns about patient compliance or cognitive side effects. Additionally, a significant percentage of patients treated with VNS will experience many QOL enhancing side effects. In many patients, the improved seizure control and the ability to substitute VNS for a medication allow the patient to experience a greatly improved QOL. VNS continues to be underused in the large number of refractory epilepsy patients who do not respond to therapy with AEDs and are not candidates for traditional epilepsy surgery. It is anticipated that treatment with VNS will assume a larger role for patients with uncontrolled epilepsy and be used in patients with less refractory seizure disorders. Recent clinical and animal studies have established the scientific foundation of the KD. In children with refractory seizures who have failed drug therapy and are not candidates for epilepsy surgery, this therapy is as or more effective than the addition of any new AED. Recent clinical and animal studies document the efficacy and scientific basis of the KD. Further experimental studies using brain-slice neurophysiology, genetic models, and cultured-cell neurons will continue to broaden our understanding of the KD. This will allow physicians to optimize the clinical use of the KD and potentially develop novel antiepileptic treatments. This could have important implications on the treatment of epilepsy in people of all ages.

Original languageEnglish (US)
Pages (from-to)371-407
Number of pages37
JournalNeurologic Clinics
Volume19
Issue number2
DOIs
StatePublished - Jan 1 2001

Fingerprint

Ketogenic Diet
Vagus Nerve Stimulation
Epilepsy
Therapeutics
Seizures
Hope
Physicians
Polypharmacy
Neurophysiology
Aptitude
Genetic Models
Patient Compliance
Anticonvulsants

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Vagus nerve stimulation and the ketogenic diet. / Wheless, James; Baumgartner, James; Ghanbari, Caroline.

In: Neurologic Clinics, Vol. 19, No. 2, 01.01.2001, p. 371-407.

Research output: Contribution to journalArticle

Wheless, James ; Baumgartner, James ; Ghanbari, Caroline. / Vagus nerve stimulation and the ketogenic diet. In: Neurologic Clinics. 2001 ; Vol. 19, No. 2. pp. 371-407.
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