My child is not recovering well in some areas with monthly Rifaximin. Can I start vagus nerve stimulation (VNS) before trying continuous (daily) Rifaximin?

The decision to try continuous rifaximin or add vagus nerve stimulation are two separate and discrete issues. If monthly cycles of rifaximin are not adequately controlling bacterial overgrowth, there will be little to no neurological gains after three months, and the increase to continuous rifaximin is warranted.nnThe addition of vagus nerve stimulation is based on whether or not neurological recovery occurs across all areas (speech, motor, socialization, hyperactivity, emotional regulation, etc.). If there is substantial improvement in some areas, but little to no improvement in others, then the addition of vagus nerve stimulation is warranted.