Mahmoud Taha and Raida Albaradi
Background: Vagus nerve stimulation is an adjunct device used for the treatment of drug-resistant (refractory)
epilepsy. Insertion of this device is usually straightforward in patients with no previous surgery or scar in the left side
of the neck or chest wall.
Methods: We present a case of 6-year-old girl who had refractory seizures and left-sided programmable
ventriculo-peritoneal shunt. VNS device were inserted and several modifications to the standard surgical procedure
were made in order to avoid the distal catheter of the shunt in the neck and in the anterior chest wall.
Results: The child had no immediate complication related to her VP shunt or her VNS device at discharge or at 3
and 6 months follow up. The stimulation was successfully initiated 2 weeks post operatively. Her seizure control
improved slightly at 6 months of stimulation.
Conclusions: The technical modification that we have performed is safe and useful in patients undergoing
insertion of VNS with left sided shunt or other implant in the left side of the neck or chest wall.
