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Drug-Resistant Epilepsy – VNS — SCE Neurology MCQ

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ModerateEpilepsy & Seizure DisordersDrug-Resistant Epilepsy – VNSSCE Neurology

A 45-year-old man with drug-resistant focal epilepsy has failed 5 antiseizure medications. He is not a candidate for resective epilepsy surgery due to bilateral temporal onset. What palliative neuromodulation device should be considered?

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Correct answer: B — Vagus nerve stimulator

Vagus nerve stimulation (VNS) is an established neuromodulation therapy for drug-resistant epilepsy when resective surgery is not feasible. It reduces seizure frequency by approximately 50% in one-third of patients. The device is implanted subcutaneously with an electrode wrapped around the left vagus nerve in the neck. A: Cochlear implants are for hearing loss. C: STN DBS is for Parkinson's disease; thalamic (ANT) DBS is used for epilepsy in some centres. D: SCS has no role in epilepsy. E: TENS is for pain.

Reference: NICE NG217 (2025); NICE IPG49 VNS for Epilepsy