Seminar: Vagus Nerve Stimulation in Epilepsy

Riëm El Tahry (UCLouvain) and Antoine Nonclercq (ULB) 

Optimisation of vagus nerve stimulation for refractory epilepsy: a translational approach

Epilepsy is a serious neurologic condition associated with stigma, psychiatric co- morbidity, and high economic costs. One third of patients with epilepsy are refractory to anti-epileptic drugs. For these patients, epilepsy surgery may be an option. If patients are not eligible for surgery, vagus nerve stimulation (VNS) can be proposed. Approximately half of treated patients achieve a good clinical response (>50% seizure frequency reduction). Despite a 30-years’ experience in the use of VNS for epilepsy, the mechanisms of action of VNS remain to be fully elucidated. Nearly one third of patients do not respond to VNS, and very little is known of why this occurs. Our global aim is to better understand the vagus nerve in an epileptic framework. More specifically, we aim (1) to investigate potential biomarkers of seizures based on vagus nerve recordings in a chronic setting in rats (2) to develop closed loop stimulation , (3) to characterize biomarkers of effective stimulation and central activation in VNS implanted patients. (4) to understand how VENG recording contributes to the understanding of death related epilepsy.