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Dr. Andrew Rynne

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Epilepsy. Psychotic, Aggressive Meltdowns. Vagus Nerve Stimulation. What Concerns Do We Need To Be Aware Of?

Hi our 22yro son has LGS & after many years of multiple drug changes & two years on the MAD diet our new Neurologist/Epileptologist has strongly suggested VNS as a option. Our son's epilepsy has always been intractable despite multiple drugs and he is getting worse especially psychotic & aggressive meltdowns. He is by nature a gentle person but obviously can not control the outbursts and it appears his personality is changing. he also takes an anti-anxiety & an anti psychotic med in his drug regimen. What is the likelihood of seeing a real difference if we opt for this therapy & what concerns if any should we have? We reside in Queensland Australia
Tue, 30 Jul 2013
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Neurologist 's  Response
Hi,
Thank you for posting your query.
I can understand the difficulty you and your family are facing due to your son's intractable epilepsy. Part of his aggressive behavior could be related to his uncontrolled epilepsy.
Here, our options are limited. Since the medications are not helping much to control the seizures, we have to go for vagal nerve stimulation (VNS). VNS is a proven, safe and effective treatment option in your son's situation.
Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: drsudhirkumar@yahoo.com
My blog: http://bestneurodoctor.blogspot.com/
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  User's Response
When seizures are difficult to control, there can be psychiatric complications such as having aggression, agitation or psychotic symptoms. Patients with poorly controlled epilepsy can also have depression and are at risk of suicide.

If these behavioural problems are unmanageable, you may need to consult a psychiatrist in addition.

Behavioural problems may worsen soon after a seizure or a cluster of seizures, in which case it is important to try everything you can to control the seizures. In this regard, you must follow your neurologist's opinion on the treatment options available and make an informed choice.

Vagal Nerve Stimulation (VNS) will directly help reduce depression along with helping to achieve control of seizures. It may not directly reduce any psychotic symptoms (delusions and hallucinations), but by controlling seizures it can indirectly reduce the severity and frequency of psychosis too.

Hope this helps.
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Epilepsy. Psychotic, Aggressive Meltdowns. Vagus Nerve Stimulation. What Concerns Do We Need To Be Aware Of?

Hi, Thank you for posting your query. I can understand the difficulty you and your family are facing due to your son s intractable epilepsy. Part of his aggressive behavior could be related to his uncontrolled epilepsy. Here, our options are limited. Since the medications are not helping much to control the seizures, we have to go for vagal nerve stimulation (VNS). VNS is a proven, safe and effective treatment option in your son s situation. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar My email: drsudhirkumar@yahoo.com My blog: http://bestneurodoctor.blogspot.com/