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Evidence to Improve Care

Electrical Stimulation for Drug-Resistant Epilepsy

Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends the use of vagus nerve stimulation for children and adults with drug-resistant epilepsy who are not candidates for surgical resection, provisional on the following:

    • Vagus nerve stimulation is incorporated into the Provincial Strategy for Epilepsy Care

    • Appropriate criteria for using vagus nerve stimulation are established

    • Outcomes of vagus nerve stimulation procedures are tracked prospectively

    • The use of vagus nerve stimulation is limited to institutions with demonstrated expertise

  • While the initial evidence on deep brain stimulation is promising, there is insufficient evidence for the Ontario Health Technology Advisory Committee to make a recommendation on the use of deep brain stimulation in adults or children with drug-resistant epilepsy at this time.

    Read the full OHTAC Recommendation report

People with epilepsy have recurring seizures. For most people with epilepsy, seizures can be controlled with medications. However, in about one-third of patients, medications do not work. This is called drug-resistant epilepsy. Surgery is another option to help control seizures, but not everyone can have the surgery.

Health Quality Ontario Reviews Electrical Stimulation for Drug-Resistant Epilepsy

Electrical stimulation involves delivering small electrical pulses to the brain to control seizures. Two of these techniques are called deep brain stimulation and vagus nerve stimulation. Electrical stimulation might be another treatment option for people with drug-resistant epilepsy.

Electrical Stimulation for Drug-Resistant Epilepsy: An Evidence-Based Analysis (PDF)
October 2013

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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry provides funding for this procedure at specialized sites.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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