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Vagus nerve stimulation for epilepsy - surgery
Vagus nerve stimulation (VNS) may be considered when epilepsy cannot be treated with brain surgery, and where epilepsy medication is not working satisfactorily.
VNS is a small device (generator) implanted under the skin on the left side of the chest. This is connected by a lead to the left vagus nerve in the neck. The stimulator periodically sends weak electrical signals through the vagus nerve to specific areas of the brain. The signals can make epileptic seizures milder, shorter, or stop them.
The stimulator cannot cure epilepsy, but it can make seizures easier, shorter, or stop them. The method can reduce the need for emergency medication, immediate assistance, and hospital admissions. Although few become completely seizure-free with VNS, more than half experience a usable to very good effect from the treatment. Many find that they have shorter and/or milder seizures, a reduced need for emergency medication, and feel more alert and energetic.
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Before the operation, you will be admitted for a 10–14 day assessment stay at the National Epilepsy Hospital (SSE). Here, you and your relatives will receive education and information about the operation. The operation is performed at the Neurosurgical Department at Oslo University Hospital, Rikshospitalet. You will be admitted on the day of the operation. If you have a long travel distance, you can stay at the hospital hotel at Rikshospitalet. You and your relatives will receive notification from the Neurosurgical Department regarding admission and any preparations before the stay. Unless otherwise instructed, you should not stop taking your anti-epilepsy medication(s) before the operation.
Under
Implanting a vagus nerve stimulator is a minor procedure that is usually performed under general anesthesia. The surgeon makes two short incisions, one on the chest and one on the left side of the neck. The stimulator is placed under the skin on the front of the chest below the collarbone. From the stimulator, a thin lead is run under the skin up to the vagus nerve on the left side of the neck. The lead is attached to the nerve here. The vagus nerve stimulator is 6.9 millimeters thick and weighs between 16 and 25 grams.
You will be given a short general anesthetic and will feel nothing during the procedure, but you may experience pain afterwards and will be offered pain medication. The operation takes from one to one and a half hours.
How long does the treatment last?
After starting VNS, it can take from a couple of months up to one to two years before we see the maximum effect of the treatment. If we don't see any positive effect 2-3 years after starting, stopping the treatment will be considered.
(Photo reproduced with permission from Cyberonics Inc.)
After
After the operation, you will usually be hospitalized for 10 days at SSE for start-up and adjustment of the stimulator. After a few days, we will start up the stimulator. You and your relatives will receive instruction and training regarding the new situation with the vagus stimulator. The stitches will be removed before you go home.
After the stimulator is started and adjusted, you may notice that you become hoarse, get a tickling sensation in your throat, or discomfort, possibly coughing. Some may experience shortness of breath, especially during physical activity. All symptoms usually occur while the stimulation is ongoing and subside after a short time.
: Adjusting the stimulator
The adjustment is performed with a computer and a rod held over the stimulator. The doctor adjusts the settings so that you get the best possible effect. You can regulate it yourself with the magnet. Using a powerful magnet that is stroked over the stimulator, you or your relatives can provide extra stimulation if needed. You can also temporarily stop the stimulator with the magnet if necessary.
Jeg elsker å gå turer i skogen og puste inn den friske luften. Det er så avslappende å være ute i naturen.
I love to go for walks in the forest and breathe in the fresh air. It's so relaxing to be out in nature.
Control
The follow-up care you receive at SSE depends on the follow-up services available locally. Approximately 6 months after the operation, there will also be an outpatient check-up at the Neurosurgical Department.
: Battery change
The battery in the VNS stimulator lasts for 3 to 10 years. The battery life depends on how strong the stimulation is and how often it occurs. If the VNS treatment is effective, the entire stimulator is replaced when the battery is depleted. Battery replacement is a minor procedure that usually requires only one incision over the chest. The procedure is performed in the Neurosurgical Department at Rikshospitalet. Afterwards, you will be admitted for a 4-5 day stay at SSE.
: Please be aware.
pasienter med VNS-stimulator bør ikke få diatermibehandling (inkluderer kortbølge-, mikrobølge-, samt ultralyddiatermi). Diagnostisk ultralyd, samt vanlig røntgen og CT (komputertomografi) er tillatt.
Patients with VNS stimulators should not receive diathermy treatment (including shortwave, microwave, and ultrasound diathermy). Diagnostic ultrasound, as well as routine X-rays and CT (computed tomography), are permitted.
MR (magnetic resonance) examinations can often be performed, with some adjustments based on the manufacturer's guidelines. It is very important to inform them that you have a VNS (Vagus Nerve Stimulator), so the examination can be adapted and carried out safely. It may be necessary to turn off the stimulator beforehand and check the stimulator after the examination.
Avoid strong impacts directly on the stimulator and/or lead, as they can be damaged by it.
You can reach our locations using public transport. Visit Agder kollektivtrafikk to find your route:akt.no
You may be entitled to have necessary expenses covered when traveling to and from the treatment location.
ities.no.
You should primarily use public transport, and you must pay a deductible. To get reimbursed for expenses incurred during the trip, you must fill out a travel expense claim form and send it to modalities.no.Patient travels.
: Practical information
At the hospital pharmacy in Kristiansand, you can drop off prescriptions and purchase pharmacy goods.
You'll find us on the 1st floor of the main building, right by the entrance. Open every weekday from 8:30 AM to 4:30 PM.
Doesn't the appointment time work? Now, if you receive your appointment letter digitally on helsenorge.no, you can send a direct message to the department you're visiting if you need to reschedule. You must be a registered user on helsenorge to access the service. You can also contact the department where you have your appointment or call the main switchboard by phone:38 07 30 00
Visiting hours may vary at the different departments and locations. Please check with the department you have an appointment with for more information.
: Kristiansand: : 5:00-7:00 PM on weekdays 14.00-16.00 and 18.00-19.00 on weekends and holidays
Postnatal ward: 4:00–6:00 PM daily for the newborn's healthy siblings.
Most hospital wards in Kristiansand have a small collection of books that patients and relatives can borrow. Contact your ward for more information and assistance.
Many people wish to bring a floral greeting when visiting a patient in the hospital, but due to allergies and the risk of infection, several of our departments are flower-free. We would appreciate it if you who wish to bring a gift for the patient choose something other than flowers.
Some patients also react allergically to perfume or creams containing perfume. We ask that this be taken into consideration.
Many patients and relatives want to take photos/videos or blog about their time at the hospital. Of course, you are welcome to do so, as long as you respect the privacy of other patients and employees.
Here are a couple of good tips for using social media for you as a patient or caregiver:
Respect others. You must have consent if you want to take pictures or videos of patients or employees. All patients are entitled to privacy when they are at the hospital.
It is the parents/guardians who decide whether you can take pictures of children or publish pictures of them online. Parents should consider what is best for the child. When the child has turned 12, great weight should be given to what the child thinks. When the child has turned 15, they themselves decide whether it is okay to be photographed and whether it should be published.
Remember that employees must also give their consent if you want to publish photos you have taken of them.
You should remove content you have published if the person it concerns asks you to. If others have posted pictures of you on the internet without permission, you can ask the person to delete them. If you are not heard, you can contact:www.delete-me.no.
: Audio recording It is not illegal to record conversations you are participating in for private use. However, publishing and sharing requires consent from the person you are speaking with. Secret recordings of conversations you are not participating in are illegal.
Our hairdresser is located on the third floor of the hospital's main building and is open to everyone. If needed, the hairdresser can come to the ward. The hairdresser also customizes wigs. Opening hours are Monday, Wednesday, and Thursday from 9:00 AM – 4:00 PM. : Book an appointment:: 94 81 59 01
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For example, this could involve hospital admission, extensive outpatient treatment, or a visit to the dentist. In these cases, your family doctor must test you for bacteria resistant to antibiotics (such as MRSA).
Please have your family doctor send you the lab results before your appointment with us and bring them with you when you come to the hospital.
Sometimes we need a space for rest and reflection. We have three such rooms available for you and your loved ones. The rooms are open to all, regardless of belief and faith.
In Arendal, you can find the hospital's quiet room/chapel in the basement of the main building. In Kristiansand, the room is located on the first floor of the main building, north entrance. Both rooms are open 24/7. In Flekkefjord, the chapel is located by the parking lot to the left of the main entrance.
There is also the possibility of holding a memorial service in the chapel in the event of a death. This is arranged by contacting the hospital chaplains.
Eg Church in Kristiansand is open every weekday between 08:00-18:00, for those who wish for a space for silence and reflection. Open from 10:00-18:00 on weekends.
Kiosk You'll find the kiosk on the 1st floor in the main building's lobby at Eg.
At the kiosk, you can buy newspapers, magazines, fruit, chocolate, cookies, ice cream, soft drinks, flowers, cards, and various gift items.
: Cafeteria "Kilden" cafeteria is located together with the kiosk and has the same opening hours.
The cafeteria serves, among other things, rolls, baguettes, salad, cakes, hamburgers, and sausages.
Parking spaces at Sørlandet Hospital are subject to a fee Monday to Friday from 8:00 AM to 8:00 PM. Anyone wishing to park on the hospital grounds must follow the signage and instructions on the payment machines.
At the hospitals in Arendal and Kristiansand, it is possible to pay for parking with EasyPark (mobile solution), card, or coins in other areas. See signage for both payment options and time limits.
At the hospital in Kristiansand, you can register your parking via the Easypark app, via the machine where you park, or the Flowbird website.
At the hospital in Arendal, cameras read vehicle registration numbers upon entering and exiting the parking garage through the Autopay service. Follow the signs and read the instructions.
Pay at the payment terminal.
If you haven't created a profile yetAutopay.ioYou can pay at the machine by the main entrance. Enter the vehicle's registration number. You can pay by card or cash, but the machine does not give change.
: Pay automatically
Register as a customer with your registration number and bank card at www.autopay.io. Once registered, you will automatically pay each time you park in the car park.
In certain periods, e.g. when there's a lot of snow, it can be difficult to find a parking space. We therefore recommend allowing plenty of time.
: For electric cars:
Arendal: Electric cars can park for free in areas with a maximum sign of 1, 2, or 3 hours. On other areas, a fee must be paid from the first hour. Kristiansand: Electric cars will pay fees from the first hour. Flekkefjord: Electric cars will pay a fee from the first hour.
Need to charge your car? Not all of our hospital areas have charging stations, and those that do have a limited number. You therefore cannot rely on being able to charge your car while you are visiting as a patient or visitor. You can see all charging stations here:
: Blood donors park for free at the hospital.: More information is available at the blood bank.
Parents of children (under 18 years) with a hospital stay of more than 14 days,You receive free parking during the child's stay. This also applies if the child's stay begins at another hospital. Contact the department at the hospital for more information.
Valid HC card gives free parking in designated areas. Contact the Service Desk to register your HC card. HC vehicles are exempt from time restrictions unless otherwise indicated on signs.
Parking for mothers in Kristiansand There is free parking for women giving birth outside the Women's Department at the hospital in Kristiansand. The maximum parking time is set to 2 hours.
The service desk in Kristiansand is located right by the main entrance. Here you can contact us with questions about your appointment at the hospital.
: Opening hours: : Weekdays: 07.30-21.00. : Saturdays, Sundays and public holidays: 08.00-21.00.
Need someone to talk to? Our hospital chaplains have extensive experience in meeting people in various life situations. They meet you on your own terms, regardless of faith, worldview, or attitude. The hospital chaplains are available around the clock, every day of the week, for patients, relatives, and staff.
Would you like to get in contact? Then you can ask the hospital staff for help, or call the main switchboard on telephone: 38 07 30 00.
Hospital chaplains also facilitate contact with other religious and belief communities.
If you need an interpreter, please inform the hospital in good time before your appointment. The costs of the interpreter are covered by the healthcare service.: The Norwegian National Health Portal
