title: Effect of vagus nerve stimulator magnet on programmable shunt settings.
abstract: OBJECTIVE
  Vagus nerve stimulators and programmable shunt valves are used in the operative care of epilepsy and hydrocephalus, respectively. Both devices use magnetic fields to activate and program their various settings and functions. The authors conducted several ex vivo trials to better elucidate any interplay between the two systems.
  
  
  METHODS
  A pulse generator controller (Cyberonics Corp., Houston, TX) was brought to within 4 cm of Strata programmable shunt valves (Medtronic Neurosurgery, Goleta, CA). Each of five valves was preset to either a low- or high-pressure setting and then challenged with the vagus nerve stimulator generator. Each valve was challenged 20 times, for a total of 100 trials.
  
  
  RESULTS
  In 100 trials, 78 inadvertent pressure setting adjustments were recorded. In 46 attempts, the valve pressure was increased, and in 34 attempts, the pressure was decreased.
  
  
  CONCLUSIONS
  This study provides some support to the anecdotal reports of inadvertent adjustments of programmable shunt valves by the external magnetic field created by vagus nerve stimulator pulse generator controllers. Further trials and a double-blind study are necessary to illustrate more clearly the possible relationship of these magnetically controlled neurosurgical devices.
authors.affiliation: Division of Neurosurgery, University of California at San Diego, Division of Neurosurgery, Children's Hospital, San Diego, California, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Jandial
authors.forename: Henry E
authors.initials: HE
authors.lastname: Aryan
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Hughes
authors.forename: Michael L
authors.initials: ML
authors.lastname: Levy
mesh_terms: D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation*; D015897:Comorbidity; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004574:Electromagnetic Fields / Q000009:adverse effects*; D004827:Epilepsy / Q000503:physiopathology / Q000628:therapy*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology / Q000628:therapy*; D008838:Microcomputers; D012984:Software; D013525:Surgical Instruments; D014630:Vagus Nerve / Q000503:physiopathology*