| Epilepsy affects approximately 1% of the population and carries with it significant morbidity. For intractable epilepsy that does not respond to medical therapy or surgical ablation procedures, a new procedure has been developed, namely unilateral vagus nerve stimulation. This latter procedure is efficacious but vagus nerve stimulation is associated with autonomic dysfunction. The aim of this study is to test the hypothesis that compared to the vagus nerve, stimulation of Hering's nerve (carotid sinus nerve) similarly blunts seizures but avoids most of the adverse effects of vagus nerve stimulation.;The results in dogs demonstrate that compared to vagus nerve stimulation, Hering's nerve stimulation more reliably eliminates observable seizure activity, and it does not cause bradycardia or cardiac arrhythmias. Epileptic seizures induced by application of penicillin to the cerebral cortex of ten dogs, are rapidly and reliably inhibited by Hering's nerve stimulation. Second, the results of tracing and blocking experiments in the dog and rat demonstrate that information from Hering's nerve reaches the cerebral cortex and that the seizure inhibitory effects of Hering's nerve stimulation is dependent on an intact amygdala. Finally, the results show that in both adult and infant humans Hering's nerve can be reliably and easily accessed. Together these studies suggest Hering's nerve stimulation is a safe and effective method for decreasing medically intractable epileptic seizure activity. |
