====== Transcutaneous vagus nerve stimulation ======

see [[Transcutaneous Vagus Nerve Stimulation for Severe Traumatic Brain Injury]]

The transcutaneous [[vagus nerve stimulation]] (tVNS) is a non-invasive technique in the treatment of [[drug-resistant epilepsy]] and results in positive effects for patients who cannot tolerate invasive vagus nerve stimulation. In a study, Wu et al. aimed to define the relationship between tVNS and seizure control, [[quality of life]] (QOL) and some other factors.

They found articles by searching through [[PubMed]] and [[Web of Science]], and a total of three articles with 280 patients overall were included. These eligible studies include two randomized double-blinded trials and one randomized single-blinded trial. [[Meta-analysis]] and [[systematic review]] were performed, analyzing the association between tVNS and seizure frequency using the available data. The responder rate, QOL and adverse effects were also analyzed.

The results showed a significant difference in seizure frequency between treatment group and control group (Z = 2.14, P = 0.03, 95% confidence interval (CI) -6.31 to -0.27; I2 = 10%). However, only two studies provided the data of responders, and the result failed to figure out a significant difference (Z = 0.75, P = 0.45, 95% CI (odds ratio) 1.47 (0.54-4.02); I2 = 61%). It is difficult to define whether tVNS improved QOL between treatment and control groups using the available data. The adverse effects seem to be very few, with the most common being a headache.

tVNS is an effective procedure to control the frequency of seizures according to the available data, especially for those patients who do not want to tolerate a surgical procedure
((Wu K, Wang Z, Zhang Y, Yao J, Zhang Z. Transcutaneous vagus nerve stimulation 
for the treatment of drug-resistant epilepsy: a meta-analysis and systematic
review. ANZ J Surg. 2020 Feb 12. doi: 10.1111/ans.15681. [Epub ahead of print]
Review. PubMed PMID: 32052569.
)).
----
Bauer S, Baier H, Baumgartner C, Bohlmann K, Fauser S, Graf W, Hillenbrand
B, Hirsch M, Last C, Lerche H, Mayer T, Schulze-Bonhage A, Steinhoff BJ, Weber Y,
Hartlep A, Rosenow F, Hamer HM. [[Transcutaneous Vagus Nerve Stimulation]] (tVNS) for
Treatment of Drug-Resistant Epilepsy: A Randomized, Double-Blind Clinical Trial
(cMPsE02). Brain Stimul. 2016 May-Jun;9(3):356-363. doi:
10.1016/j.brs.2015.11.003. Epub 2016 Jan 20. PubMed PMID: 27033012.