When the magnet is swept over the pulse generator site, extra stimulation is delivered regardless of the treatment schedule. Patients are provided with a handheld magnet (Magnet Bracelet, Figure 4) to control the stimulator at home (which must be activated by the physician to magnet mode). The device runs continuously and is programmed to turn on and shut off for specific periods of time - for example, 30 seconds on and 5 minutes off. The amount of stimulation varies by case but is usually initiated at a low level and slowly increased to a suitable level for the individual. The strength and duration of the electrical impulses are programmed. The treating neurologist programs the stimulator in his or her office with a small hand-held computer, programming software and a programming wand (Programming Wand, Figure 3). The stimulator is most commonly activated two to four weeks after implantation, although in some cases it may be activated in the operating room at the time of implantation. When the battery is low, the stimulator is replaced with a less invasive procedure which requires only opening the chest wall incision. The stimulator contains a battery, which can last from one to 15 years. The device or implant is a flat, round piece of metal that measures about an inch and a half (4 centimeters) across and 10-13 mm thick, depending on the model used (Pulse Generator, Figure 1). This is where the thin, flexible wires that connect the pulse generator to the vagus nerve are inserted (Lead, Figure 2). A second incision is made horizontally on the left side of the lower neck, along a crease of skin. The first one is made on the upper left side of the chest where the pulse generator is implanted (Pulse Generator, Figure 1). The procedure requires two small incisions. Other surgical risks of VNS include inflammation or pain at the incision site, damage to nearby nerves and nerve constriction. As with all surgeries, there is a small risk of infection. It is usually performed on an outpatient basis. This procedure, performed by a neurosurgeon, usually takes about 45-90 minutes with the patient most commonly under general anesthesia. Lung diseases or disorders (shortness of breath, asthma, etc.).Dysautonomias (abnormal functioning of the autonomic nervous system).Heart arrhythmias or other heart abnormalities.Receiving other concurrent forms of brain stimulation.Individuals with any of the following criteria may potentially be unsuitable candidates for VNS: It is important to keep in mind that VNS is a treatment option limited to select individuals with epilepsy or treatment-resistant depression. There is no physical involvement of the brain in this surgery and patients cannot generally feel the pulses. Vagus nerve stimulation (VNS) sends regular, mild pulses of electrical energy to the brain via the vagus nerve, through a device that is similar to a pacemaker. It is connected to both motor and sensory functions in the sinuses and esophagus. It is connected to motor functions in the voice box, diaphragm, stomach and heart and sensory functions in the ears and tongue. The nerve passes through the neck as it travels between the chest and abdomen and the lower part of the brain. The vagus nerve is one of 12 pairs of cranial nerves that originate in the brain and is part of the autonomic nervous system, which controls involuntary body functions. Make an appointment with your neurologist to turn your VNS Therapy device back on.Vagus Nerve Stimulation | American Association of Neurological Surgeons.If you feel any discomfort during the MRI, immediately notify the MRI technician.Do not bring your patient magnet into the MRI scanner room.Inform the radiologist and MRI technicians of your implanted VNS Therapy ® device and your seizure disorder.Remember to bring your Patient MRI Form.Your neurologist will temporarily turn your VNS Therapy device OFF and give you a copy of the Patient MRI Form to take to the MRI center.This information can be found on the Patient MRI Form which will be provided by your neurologist. Provide the model number of your implanted VNS Therapy device, as well as the name and contact information of your neurologist.When you call to make an appointment for an MRI, inform the MRI center that you have a VNS Therapy™ device implanted.Contact your neurologist to discuss your upcoming MRI.Follow these steps before, during and after an MRI with VNS Therapy
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