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Vagus nerve stimulator for epilepsy – surgery
A vagus nerve stimulator (VNS) may be considered when epilepsy cannot be treated with brain surgery and epilepsy medications do not work satisfactorily.
A VNS is a small device (generator) that is implanted under the skin on the left side of the chest. It is connected by a wire to the left vagus nerve in the neck. The stimulator sends weak electrical signals at regular intervals through the vagus nerve to specific areas of the brain. The signals may make epileptic seizures milder or shorter, or stop them.
The stimulator cannot cure epilepsy, but it can make seizures milder or shorter, or stop them. The method can reduce the need for emergency medication, emergency care and hospital admissions. Although few people become completely seizure-free with VNS, more than half experience a useful to very good effect from the treatment. Many find that their epileptic seizures are shorter and/or milder, that they need less emergency medication, and that they feel more alert and refreshed.
Before the operation, you will be admitted to the National Centre for Epilepsy (SSE) for a 10–14-day assessment stay. You and your relatives will receive education and information about the operation. The operation is performed by the Department of Neurosurgery at Oslo University Hospital, Rikshospitalet. You will be admitted on the day of the operation. If you have a long journey, you can stay at the hospital hotel at Rikshospitalet. The Department of Neurosurgery will inform you and your relatives about the admission and any preparations needed before your stay. Unless you have been told otherwise, do not stop taking your epilepsy medication before the operation.
During
Implanting a vagus nerve stimulator is a minor procedure that is usually performed under a short general anaesthetic. The surgeon makes two small 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. A thin wire is passed under the skin from the stimulator to the vagus nerve on the left side of the neck. The wire is attached to the nerve. The vagus nerve stimulator is 6.9 millimetres thick and weighs between 16 and 25 grams.
You will be given a short general anaesthetic and will not feel anything during the procedure, but you may have pain around the wound afterwards. You will be offered pain-relieving medication. The operation takes between one and one and a half hours.
How long does the treatment last?
After VNS treatment starts, it may take from a couple of months to one or two years before we see the maximum effect of the treatment. If we see no positive effect 2–3 years after treatment starts, stopping the treatment will be considered.
(Photo reproduced with permission from Cyberonics Inc.)
After
After the operation, you will usually be admitted to SSE for 10 days to start and adjust the stimulator. We start the stimulator after a few days. You and your relatives will receive education and training about the new situation with a vagus nerve stimulator. The stitches are removed before you go home.
After the stimulator has been started and adjusted, you may notice that your voice becomes hoarse, you feel a tickling sensation in your throat or discomfort, or you may cough. Some people may experience shortness of breath, especially during physical activity. Symptoms usually occur while stimulation is in progress and subside after a short time.
Adjusting the stimulator
The stimulator is adjusted using a computer and a wand held over the device. The doctor adjusts the settings to give you the best possible effect. You can control it yourself using the magnet. By passing a strong magnet over the stimulator, you or your relatives can deliver extra stimulation when needed. You can also temporarily stop the stimulator with the magnet if necessary.
Follow-up
The follow-up you receive at SSE depends on the local follow-up services available to you. You will also have an outpatient check-up at the Department of Neurosurgery approximately 6 months after the operation.
Battery replacement
The battery in the VNS stimulator runs out after 3 to 10 years. Battery life depends on the strength and frequency of stimulation. If VNS treatment has a positive effect, 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 by the Department of Neurosurgery at Rikshospitalet. Afterwards, you will be admitted to SSE for 4–5 days.
Please note
Patients with a VNS stimulator should not receive diathermy treatment (including short-wave, microwave and ultrasound diathermy). Diagnostic ultrasound, as well as ordinary X-rays and CT (computed tomography), are permitted.
MRI (magnetic resonance imaging) examinations can often be performed with some adjustments in accordance with the manufacturer’s guidelines. It is very important to inform staff that you have a VNS so the examination can be adapted and carried out safely. It may be necessary to switch off the stimulator beforehand and check it after the examination.
Avoid strong blows directly to the stimulator and/or wire, as they may damage them.
You can reach our locations by public transport. Visit Agder public transport to find your route:akt.no
You may be entitled to reimbursement of necessary expenses when travelling to and from your place of treatment.
As a general rule, you should use public transport, and you must pay a deductible. To be reimbursed for travel expenses you have paid, you must complete a travel expense claim form and send it toPatient travel.
The hospital bus is a transport service for patients between the hospitals in Arendal and Kristiansand.
There is also a route running between Vigeland, Mandal and Kristiansand in both directions.
Does your appointment time not suit you? If you receive your appointment letter digitally on helsenorge.no, you can now send a message directly to the department you are visiting if you need a new appointment time. You must be a registered user of Helsenorge to access the service. You can also contact the department where you have an appointment or call the switchboard at:38 07 30 00
Children and young people are affected when someone in the family is ill and need to understand what is happening. You may be a patient yourself, a relative, or a parent of sick children with siblings. We at the hospital will help ensure that the children and young people in your family are well cared for.
Kristiansand: 17:00–19:00 on weekdays 14:00–16:00 and 18:00–19:00 on weekends and public holidays
Postnatal ward: 16:00–18:00 every day for the newborn’s healthy siblings.
Most of the inpatient wards in Kristiansand have a small collection of books that patients and relatives can borrow. Contact your department for more information and assistance.
Many people wish to bring flowers when visiting a patient in hospital, but due to allergies and the risk of infection, several of our departments do not allow flowers. If you would like to bring the patient a gift, we appreciate you choosing something other than flowers.
Some patients are also allergic to perfume or perfumed creams. We ask you to take this into consideration.
Many patients and relatives want to take photos/videos or blog about their time in hospital. This is of course permitted, as long as you respect the privacy of other patients and staff.
Here are a few useful tips on using social media for patients and relatives:
Be considerate of others. You must have consent if you want to take photos or videos of patients or staff. All patients are entitled to privacy while in hospital.
Parents/guardians decide whether you may take photos of children or publish photos of their children online. Parents should consider what is best for the child. Once the child has turned 12, their views must be given significant weight. Once the child has turned 15, they decide for themselves whether they are comfortable being photographed and whether the images may be published.
Remember that staff must also give their permission if you want to publish photos you have taken of them.
You should remove content you have published if the person concerned asks you to. If someone has posted photos of you online without permission, you can ask them to delete them. If they do not listen, you can contact:www.slettmeg.no.
Audio recording It is not illegal to record conversations you take part in for private use. However, publishing and sharing recordings requires consent from the person you are speaking with. Secretly recording conversations you are not part of is 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 fits wigs. Opening hours are Monday, Wednesday and Thursday from 09:00 to 16:00. Book an appointment: 94 81 59 01
Have you worked in healthcare or received healthcare outside the Nordic countries during the past year?
This may include, for example, a hospital stay, extensive outpatient treatment or a visit to the dentist. In that case, your GP must test you for antibiotic-resistant bacteria (such as MRSA).
Ask your GP to send you the test results before your appointment with us, and bring them with you when you come to the hospital.
Sometimes we need a room for rest and reflection. We have three such rooms available for you and your loved ones. The rooms are open to everyone, regardless of their beliefs or faith.
In Arendal, you will find the hospital’s quiet room/chapel on the basement level of the main building. In Kristiansand, the room is on the first floor of the main building, north entrance. Both rooms are open 24 hours a day. In Flekkefjord, the chapel is by the car park to the left of the main entrance.
It is also possible to hold a memorial service in the chapel following a death. To arrange this, contact the hospital chaplains.
Eg church in Kristiansand is open on weekdays from 08:00 to 18:00 for anyone who would like a quiet place for reflection. Open from 10:00 to 18:00 at weekends.
Kiosk You will find the kiosk on the ground floor in the main building’s lobby at Eg.
Opening hours: Monday–Friday: 08:00–20:00 Saturday and Sunday: 09:30–20:00
The kiosk sells newspapers, magazines, fruit, chocolate, biscuits, ice cream, soft drinks, flowers, cards and various gift items, among other things.
Cafeteria The “Kilden” cafeteria is located next to the kiosk and has the same opening hours.
The cafeteria serves rolls, baguettes, salads, cakes, hamburgers and hot dogs, among other things.
If you have a serious illness that requires treatment or follow-up over a period of time, you may be entitled to be assigned a contact doctor in specialist healthcare.
The contact doctor scheme in specialist healthcare is intended to ensure that your follow-up as a patient is better, safer and more effective. Having a contact doctor is a patient right and an obligation for specialist healthcare services.
The contact doctor’s duties
The contact doctor has a special responsibility for following up with you during treatment or follow-up in specialist healthcare. The contact doctor’s duties are to:
be your regular medical contact throughout your course of care
be involved in your treatment or follow-up
keep informed about the status of your treatment
help ensure that your course of care proceeds as planned
contact the relevant staff/treatment unit if there are challenges with your course of care
provide information to you and your relatives
be available to you and healthcare professionals for medical questions
We encourage everyone to use their mobile phones considerately and be mindful of other patients. It is important to put your phone on silent at night and on silent or vibrate during the day. Out of consideration for other patients, it is a good idea to leave the room if you need to have a long conversation.
Parking at Sørlandet Hospital is subject to a fee Monday to Friday from 08:00 to 20:00. Anyone wishing to park on hospital grounds must follow the signs and instructions on the payment machines.
At the hospitals in Arendal and Kristiansand, you can pay for parking with EasyPark (mobile app) or by card at the other locations. See the signs for payment options and time limits.
At the hospital in Kristiansand, you can register your parking using the EasyPark app, at the machine where you park, or on the Flowbird website.
At the hospital in Arendal, cameras read vehicles’ registration numbers as they enter and leave the parking garage using the Autopay service. Follow the signs and read the instructions.
Pay at the payment machine
If you have not created a profile onAutopay.io, you can pay at the machine by the main entrance. Enter the vehicle’s registration number. You can pay by card.
Pay automatically
Register as a customer using your registration number and bank card at www.autopay.io. Once registered, you will pay automatically every time you park in the parking garage.
At certain times, for example when there is heavy snowfall, it can be difficult to find a parking space. We therefore recommend allowing plenty of time.
For electric cars:
Electric cars are charged a fee from the first hour.
Need to charge your car? Not all our hospital sites have charging stations, and those that do have a limited number. You therefore cannot count on being able to charge your car while you are at the hospital as a patient or visitor. You can see all charging stations here:
Blood donors can park at the hospital free of charge. For further information, contact the blood bank.
Guardians of children (under 18) with a hospital stay of more than 14 days,receive free parking for the remainder of the child’s stay. This also applies if the child’s stay begins at another hospital. Contact the hospital department for more information.
A valid disabled parking permit entitles you to free parking in designated spaces Contact the Service Desk to register your disabled parking permit. Vehicles displaying a disabled parking permit are exempt from time limits unless otherwise indicated on the signs.
Parking for expectant mothers, Kristiansand Free parking is available for expectant mothers outside the Women’s Department at the hospital in Kristiansand. The maximum parking time is 2 hours.
Smoking can cause discomfort to others. Thank you for being considerate and helping to ensure that Sørlandet Hospital is a smoke-free environment.
The Service Desk in Kristiansand is located right by the main entrance. You can contact the Service Desk with questions about your hospital appointment.
Opening hours: Weekdays: 07.30-21.00. Saturdays, Sundays and public holidays: 08.00-21.00.
Do you need someone to talk to? Our hospital chaplains have extensive experience supporting people in a variety of life situations. They meet you on your terms, regardless of your faith, beliefs or outlook on life. The hospital chaplains are available 24 hours a day, 7 days a week, for patients, relatives and staff.
Would you like to get in touch? You can ask hospital staff to help, or call the switchboard on: 38 07 30 00.
The hospital chaplains can also put you in touch with other faith and belief communities.
If you need an interpreter, please inform the hospital well in advance of your appointment. Interpreter costs are covered by the health service.Helsenorge.no
