{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:47:19Z","timestamp":1780634839020,"version":"3.54.1"},"reference-count":41,"publisher":"FapUNIFESP (SciELO)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Neuro-Psiquiatr."],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:p>Epilepsy comprises a set of neurologic and systemic disorders characterized by recurrent spontaneous seizures, and is the most frequent chronic neurologic disorder. In patients with medically refractory epilepsy, therapeutic options are limited to ablative brain surgery, trials of experimental antiepileptic drugs, or palliative surgery. Vagal nerve stimulation is an available palliative procedure of which the mechanism of action is not understood, but with established efficacy for medically refractory epilepsy and low incidence of side-effects. In this paper we discuss the recommendations for VNS use as suggested by the Brazilian League of Epilepsy and the Scientific Department of Epilepsy of the Brazilian Academy of Neurology Committee of Neuromodulation.<\/jats:p>","DOI":"10.1590\/0004-282x20130116","type":"journal-article","created":{"date-parts":[[2014,1,16]],"date-time":"2014-01-16T17:03:50Z","timestamp":1389891830000},"page":"902-906","source":"Crossref","is-referenced-by-count":20,"title":["Vagus nerve stimulator in patients with epilepsy: indications and recommendations for use"],"prefix":"10.1590","volume":"71","author":[{"given":"Vera C","family":"Terra","sequence":"first","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil; Academia Brasileira de Neurologia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Amorim","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Silvado","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil; Academia Brasileira de Neurologia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Juliao de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Lisa","family":"Jorge","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Faveret","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Ragazzo","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano De","family":"Paola","sequence":"additional","affiliation":[{"name":"Liga Brasileira de Epilepsia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/S0140-6736(06)68477-8","article-title":"Adult epilepsy","volume":"367","author":"Duncan JS","year":"2006","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/epi.12000","article-title":"Novel approaches to epilepsy treatment","volume":"54","author":"S\u00f8rensen AT","year":"2013","journal-title":"Epilepsia"},{"key":"ref3","author":"Rizzi M","year":"2012"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/j.1528-1167.2009.02397.x","article-title":"Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies","volume":"51","author":"Kwan P","year":"2010","journal-title":"Epilepsia"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/978-3-7091-1360-8_7","article-title":"Critical review of palliative surgical techniques for intractable epilepsy","volume":"39","author":"Fauser S","year":"2012","journal-title":"Adv Tech Stand Neurosurg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.ejpn.2012.01.001","article-title":"Clinical outcomes, quality of life, and costs associated with implantation of vagus nerve stimulation therapy in pediatric patients with drug-resistant epilepsy","volume":"16","author":"Helmers SL","year":"2012","journal-title":"Eur J Paediatr Neurol"},{"key":"ref7","series-title":"Operative Neurosurgical Techniques: Indications, Methods and Results","first-page":"1413","volume-title":"Section of the corpus callosum for epilepsy","author":"Roberts DM","year":"2006"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.seizure.2009.03.003","article-title":"Evaluation of efficacy and safety of anterior corpus callosotomy with keyhole in refractory seizures","volume":"18","author":"Ping Z","year":"2009","journal-title":"Seizure"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1227\/NEU.0b013e31822b30cd","article-title":"Neuromodulation in epilepsy","volume":"69","author":"Al-Otaibi FA","year":"2011","journal-title":"Neurosurgery"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1111\/j.1528-1167.2005.00283.x","article-title":"Vagus nerve stimulation induces concomitant respiratory alterations and a decrease in SaO <sub>2<\/sub> in children","volume":"46","author":"Zaaimi B","year":"2005","journal-title":"Epilepsia"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/j.1528-1157.1998.tb01151.x","article-title":"Vagus nerve stimulation","volume":"39","author":"Schachter SC","year":"1998","journal-title":"Epilepsia"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.brainres.2006.08.048","article-title":"Increased extracellular concentrations of norepinephrine in cortex and hippocampus following vagus nerve stimulation in the rat","volume":"1119","author":"Roosevelt RW","year":"2006","journal-title":"Brain Res"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1037\/0735-7044.118.1.79","article-title":"The effects of peripheral vagal nerve stimulation at a memory-modulating intensity on norepinephrine output in the basolateral amygdala","volume":"118","author":"Hassert DL","year":"2004","journal-title":"Behav Neurosci"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/S0006-8993(10)80038-1","article-title":"Neurochemical effects of vagus nerve stimulation in humans","volume":"583","author":"Hammond BM","year":"1992","journal-title":"Brain Res"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1046\/j.1528-1157.2002.16102.x","article-title":"Cerebral activation during vagus nerve stimulation","volume":"43","author":"Narayanan JT","year":"2002","journal-title":"Epilepsia"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1111\/j.1528-1157.1996.tb01033.x","article-title":"Vagus nerve stimulation induces a sustained anticonvulsant effect","volume":"37","author":"Takaya M","year":"1996","journal-title":"Epilepsia"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1212\/WNL.52.6.1166","article-title":"Acute blood flow changes and efficacy of vagus nerve stimulation in partial epilepsy","volume":"52","author":"Henry TR","year":"1999","journal-title":"Neurology"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1046\/j.1528-1157.2002.08202.x","article-title":"Effect of vagal nerve stimulation on interictal epileptiform discharges: a scalp EEG study","volume":"43","author":"Kuba R","year":"2002","journal-title":"Epilepsia"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1111\/j.1528-1157.1992.tb01751.x","article-title":"Inhibition of experimental seizures in canines by repetitive vagal stimulation","volume":"33","author":"Zabara J","year":"1992","journal-title":"Epilepsia"},{"key":"ref20","article-title":"Controlling seizures by changing GABA receptor sensitivity","volume":"28","author":"Zabara J","year":"1987","journal-title":"Epilepsia"},{"key":"ref21","doi-asserted-by":"crossref","DOI":"10.1016\/0013-4694(85)90626-1","article-title":"Peripheral control of hypersynchronous discharge in epilepsy","volume":"61","author":"Zabara J","year":"1985","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1111\/j.1528-1157.1990.tb05852.x","article-title":"Effects of vagal stimulation on experimentally induced seizures in rats","volume":"31","author":"Woodbury DM","year":"1990","journal-title":"Epilepsia"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/j.1540-8159.1991.tb04053.x","article-title":"Vagal stimulation reduces the severity of maximal electroshock seizures in intact rats: use of a cuff electrode for stimulating and recording","volume":"14","author":"Woodbury JW","year":"1991","journal-title":"PACE"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1111\/j.1528-1157.1990.tb05844.x","article-title":"Feasibility and safety of vagal stimulation in monkey model","volume":"3l","author":"Lockard JS","year":"1990","journal-title":"Epilepsia"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1528-1157.1994.tb02482.x","article-title":"Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures","volume":"35","author":"Ben-Menachem E","year":"1994","journal-title":"Epilepsia"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1212\/WNL.53.8.1731","article-title":"Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. The vagus nerve stimulation study group E01-E05","volume":"53","author":"Morris GL 3rd","year":"1999","journal-title":"Neurology"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/j.1528-1167.2006.00467.x","article-title":"Cardiac autonomic control in patients with refractory epilepsy before and during vagus nerve stimulation treatment: a one-year follow-up study","volume":"47","author":"Ronkainen E","year":"2006","journal-title":"Epilepsia"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1006\/ebeh.2000.0046","article-title":"A pilot study of mood in epilepsy patients treated with vagus nerve stimulation","volume":"1","author":"Harden CL","year":"2000","journal-title":"Epilepsy Behav"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.4088\/JCP.v66n0902","article-title":"Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes","volume":"66","author":"Nahas Z","year":"2005","journal-title":"J Clin Psychiatry"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/j.1528-1167.2006.00377.x","article-title":"Refractory generalized seizures: response to corpus callosotomy and vagal nerve stimulation","volume":"47","author":"Nei M","year":"2006","journal-title":"Epilepsia"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1111\/j.1528-1167.2009.02190.x","article-title":"Vagus nerve stimulation induces changes in respiratory sinus arrhythmia of epileptic children during sleep","volume":"50","author":"Zaaimi B","year":"2009","journal-title":"Epilepsia"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.seizure.2003.09.009","article-title":"Vagus nerve stimulation for 1 year in 269 patients on unchanged antiepileptic drugs","volume":"13","author":"Labar D","year":"2004","journal-title":"Seizure"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1212\/WNL.55.10.1450","article-title":"Effects of vagus nerve stimulation on respiration during sleep: a pilot study","volume":"55","author":"Malow BA","year":"2000","journal-title":"Neurology"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S0022-3476(99)70241-6","article-title":"Left vagal nerve stimulation in children with medically refractory epilepsy. The Pediatric VNS Study Group","volume":"134","author":"Murphy JV","year":"1999","journal-title":"J Pediatr"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/j.1528-1167.2006.01019.x","article-title":"Vagus nerve stimulation therapy induces changes in heart rate of children during sleep","volume":"48","author":"Zaaimi B","year":"2007","journal-title":"Epilepsia"},{"key":"ref36","article-title":"Vagus nerve stimulation in pediatric epilepsy patients: is this really worthwhile?","volume":"53","author":"Terra VC","year":"2012","journal-title":"Epilepsia"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"S55","DOI":"10.1111\/j.1600-0404.2007.00848.x","article-title":"Is vagus nerve stimulation a treatment option for patients with drug-resistant idiopathic generalized epilepsy?","volume":"187","author":"Kostov H","year":"2007","journal-title":"Acta Neurol Scand"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S1059-1311(03)00147-X","article-title":"Vagus nerve stimulation for refractory idiopathic generalized epilepsy","volume":"13","author":"Ng M","year":"2004","journal-title":"Seizure"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1111\/j.1528-1157.2000.tb00293.x","article-title":"Effects of vagus nerve stimulation on progressive myoclonus epilepsy of Unverricht-Lundborg type","volume":"41","author":"Smith B","year":"2000","journal-title":"Epilepsia"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.3171\/2011.7.JNS11977","article-title":"Vagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response","volume":"115","author":"Englot DJ","year":"2011","journal-title":"J Neurosurg"},{"key":"ref41","article-title":"Tolerability of rapid initiation and titration of vagus nerve stimulation (VNS)","volume":"45","author":"Campagna-Gibson ML","year":"2004","journal-title":"Epilepsia"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/anp\/v71n11\/0004-282X-anp-71-11-0902.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T17:02:34Z","timestamp":1495904554000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-282X2013001200902&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11]]},"references-count":41,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["S0004-282X2013001200902"],"URL":"https:\/\/doi.org\/10.1590\/0004-282x20130116","relation":{},"ISSN":["0004-282X"],"issn-type":[{"value":"0004-282X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11]]}}}