Effect of vagus nerve stimulator magnet on programmable shunt settings.
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.
Jandial
Rahul
R
Division of Neurosurgery, University of California at San Diego, Division of Neurosurgery, Children's Hospital, San Diego, California, USA.
Aryan
Henry E
HE
Hughes
Samuel A
SA
Levy
Michael L
ML
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*