Trial to Assess Vagus Nerve Stimulation Therapy vs. Anti-epileptic Drug Treatment in Children With Refractory Seizures

Inclusion Criteria:

1. Refractory seizures
2. Having tried at least two appropriate anti-epileptic drugs (AEDs) tested to tolerance or to blood levels at upper end of the target range of which at least 2 have been tolerated at normal dose;
3. Having at least 3 appropriate AEDs left to try
4. Having his/her current AED medication at an optimal dose at baseline
5. At least three seizures per month (average over 2 months prior to admission), excluding absences.
6. No more than four (4) weeks between seizures (over 2 months prior to admission)
7. Age 17 years or less
8. Having been evaluated for epilepsy surgery and resective surgery not felt indicated or patient/parents/legal guardian declined.
9. Patient is a male or patient is a nonpregnant female adequately protected from conception. Females of childbearing potential must use an acceptable method of birth control. Abstinence is an acceptable means of birth control
10. Patient or legal guardian understands study procedures and has voluntarily signed an informed consent in accordance with institutional policies.

Exclusion Criteria:

1. Having tried less then 2 AEDs tested to tolerance or to blood levels at upper end of the target range of which at least 2 have been tolerated at normal doses in the patient's lifetime
2. A progressive neurological condition (e.g. brain tumor etc.)
3. Inability of the parents or reluctance of the child to comply with the frequency of clinic visits during the treatment phase
4. Patient has a history of noncompliance for seizure diary completion.
5. Patient has taken an investigational drug within a period of five times the mean elimination half-life of the investigational drug plus two weeks.
6. Patient is currently using another investigational device or drug.
7. Patient is likely to require a whole body Magnetic resonance imaging (MRI) after VNS Therapy device implantation. (Refer to the Physician's Manual for the NCP Generator for additional information on the use of MRI.)
8. Patient is currently receiving or likely to receive short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy after implantation (Refer to Physician's Manual for the VNS (Vagus Nerve Stimulation) Therapy device for additional information on the contraindicated use of diathermy).
9. Patient was previously enrolled in this or any other VNS Therapy device Study.
10. Patient has an active peptic ulcer
11. Patient has another unstable medical condition likely to precipitate seizures and make it difficult to evaluate to evaluate efficacy (e.g. diabetes)
12. Patient has had a unilateral or bilateral cervical vagotomy.
13. Patient is pregnant at the time of enrolment.