BACKGROUND: In patients with medically refractory seizures, vagal nerve stimulation is becoming an increasingly common adjunctive therapy. Although its safety and efficacy have been proven in the general population, little is known about its use during pregnancy.
CASE: A 19-year-old primigravid woman presented during the first trimester for routine prenatal care. She had a past medical history significant for generalized tonic–clonic seizure disorder since childhood. Multiple medical regimens had failed, and a vagal nerve stimulator was implanted approximately 2 months before conception. The patient continued to take phenytoin, with improved seizure control. She had a term spontaneous delivery complicated by mild preeclampsia.
CONCLUSION: Adjunctive treatment of medically refractory seizures with a vagal nerve stimulator is a viable option during pregnancy.
Vagal nerve stimulator use throughout pregnancy successfully controlled medically refractory seizures with no adverse fetal or maternal outcomes.
From the Departments of Obstetrics and Gynecology, University of Tennessee Medical Center, Knoxville, Tennessee; and Washington University in Saint Louis, Saint Louis, Missouri.
Corresponding author: Molly V. Houser, Campus Box 8064, 660 S. Euclid Ave., St. Louis, MO 63110; e-mail: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflicts of interest.