VAGUS NERVE STIMULATION (VNS) INFORMED CONSENT
This page was last updated: October 11, 2014
WHAT IS VAGUS NERVE STIMULATION? 
Vagus nerve stimulation is a surgical operation for poorly controlled seizures, but does not involve surgery on the brain. A small pacemaker-like device is placed under the skin. This periodically stimulates the vagus nerve in the side of the neck  with an electrical current, thus reducing seizure frequency and severity. The vagus nerve serves as one of many highways of information carrying messages to and from the brain. Nerve fibers in the vagus nerve relay information from the body's organs (such as the stomach and heart) to the brain. The vagus nerve has many connections to areas in the brain instrumental in producing seizures. Recently, vagus nerve stimulation was approved as an adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments. In addition to treatment-resistant depression and drug-resistant epilepsy indications, VNS Therapy is at various stages of investigational clinical studies as a potential treatment for anxiety disorders, Alzheimer's disease, bulimia and chronic headache / migraine.

HOW IS VAGUS NERVE STIMULATION DONE?
A device, approximately the size of a silver dollar, is implanted under the skin in the upper left chest area. This
device, known as the generator, functions as a "pacemaker".  A connecting wire, also implanted under the skin, connects
this "pacemaker" to the left vagus nerve.

HOW LONG DOES THE OPERATION TAKE?
The operation to implant a vagus nerve stimulator takes approximately one hour. It is performed under general anesthesia on an outpatient basis (day surgery).  For post operative instructions, click here.
 
WHAT ARE THE SIDE EFFECTS AND COMPLICATIONS OF VAGUS NERVE STIMULATION? 
Fortunately, the complications of this operation are uncommon and seldom serious. They include pain on swallowing in
the immediate post-operative period, changes in voice or hoarseness, cough, and like any other surgical operation,
wound infection and bleeding.  Finally, there will be a scar in the left side of the neck and in the left side of the chest, near the shoulder.  Generator batteries have an expected life of approximately eight to ten years. Upon expiration of the battery, the VNS Pulse Generator is removed and a new one is implanted in a short, out-patient procedure using local anesthesia.

I / We have been given an opportunity to ask questions about my condition, alternative forms of treatment, risks of non-treatment, the procedures to be used, and the risks and hazards involved, and I/we have sufficient information to give this informed consent. I/We certify this form has been fully explained to me/us, and I/we understand its contents. I/We understand every effort will be made to provide a positive outcome, but there are no guarantees.

Patient or Legal Guardian:__________________________________________________________________________

Witness:_________________________________________________________________Date___________________


www.ghorayeb.com
Otolaryngology Houston

Bechara Y. Ghorayeb, MD
OTOLARYNGOLOGY - HEAD & NECK SURGERY
Memorial Hermann Professional Building
1140 Business Center Drive, Suite 560
Houston, Texas 77043
For appointments, call: 713 464 2614