Question 1

You often prescribe VNS for 5 minutes a day for children. If I use it longer will that improve recovery?

Accepted Answer

Although five minutes of VNS per day seems insignificant, it has the potential to lower systemic inflammation for 24-36 hours.  The need to increase tVNS to more than five minutes per day rarely occurs in children under twenty.  If there is no significant improvement within this age group, the cause of no neurological improvement is likely due to a relapse of intestinal bacteria overgrowth rather than the tVNS not being effective.  This scenario would need to be addressed with another round of rifaximin, initiating cyclic or continuous rifaximin, or if the patient is on inulin, I consider it to be inulin failure, and I replace inulin with rifaximin.  Again, I always look for an external factor such as an intensely stressful situation, supplements, homeopathic remedies, or a probiotic that might be preventing or masking recovery.nnNOTE: There is an exception to the five minutes of tVNS per day rule in children under twenty-five. Parents will often notice that after just five minutes of tVNS, their child may experience a prolonged calming effect that can last for a few hours.  In these cases, I suggest the tVNS be used at least once daily to control inflammation and an additional two to three five-minute increments as needed to control anxiety.

Question 2

You often prescribe VNS for 5 minutes a day for children. If I use it longer will that improve recovery?

Accepted Answer

Although five minutes of VNS per day seems insignificant, it has the potential to lower systemic inflammation for 24-36 hours.  The need to increase tVNS to more than five minutes per day rarely occurs in children under twenty.  If there is no significant improvement within this age group, the cause of no neurological improvement is likely due to a relapse of intestinal bacteria overgrowth rather than the tVNS not being effective.  This scenario would need to be addressed with another round of rifaximin, initiating cyclic or continuous rifaximin, or if the patient is on inulin, I consider it to be inulin failure, and I replace inulin with rifaximin.  Again, I always look for an external factor such as an intensely stressful situation, supplements, homeopathic remedies, or a probiotic that might be preventing or masking recovery.nnNOTE: There is an exception to the five minutes of tVNS per day rule in children under twenty-five. Parents will often notice that after just five minutes of tVNS, their child may experience a prolonged calming effect that can last for a few hours.  In these cases, I suggest the tVNS be used at least once daily to control inflammation and an additional two to three five-minute increments as needed to control anxiety.