Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%–40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.

中文翻译：

---

迷走神经刺激治疗耐药性癫痫

迷走神经刺激 (VNS) 是耐药性癫痫的一种神经调节治疗选择。在随机对照试验中，VNS 植入使 26%–40% 的患者在 1 年内癫痫发作频率降低了 50% 以上。长期不受控制的研究表明，随着时间的推移，对 VNS 的反应会更好；然而，对其他潜在预测因素的评估导致了相互矛盾的结果。尽管最初设计用于治疗局灶性癫痫发作，但其用途已扩展到其他形式的耐药性癫痫。在这篇综述中，我们讨论了支持使用 VNS 的证据、它对癫痫发作频率和生活质量的影响，以及这种疗法的常见不良反应。我们还包括对 VNS 原位患者的处理和管理的实用指南。