Titrating and Dosing Device Therapy for DRE: Best Practices for Optimizing Patient Outcomes

Titrating and Dosing Device Therapy for DRE: Best Practices for Optimizing Patient Outcomes

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How do you titrate & dose a patient on VNS therapy? Experts discuss best practices in adult & pediatric patients with add-on neuromodulation for DRE.

Available credits: 0.25

Time to complete: 15 minutes


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  • Overview

    Vagus nerve stimulation (VNS) therapy is an add-on neuromodulation treatment designed for adults and children diagnosed with drug-resistant epilepsy (DRE). The device delivers mild pulses to the brain through the vagus nerve to help prevent seizures before they start and help stop them if they do. Join Drs. Danielle Becker, John Stern, Deborah Holder, and Ahmed Abdelmoity as they discuss best practices for initiating, titrating, and dosing adult and pediatric patients to optimize outcomes.


    0:00 – 9:29 Chapter 1: Adult VNS Case
    9:30 – 17:14 Chapter 2: Pediatric VNS Case

  • Disclosure of Conflicts of Interest

    In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative (GLC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company. GLC mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs.

    Danielle Becker, MD, MS, FAES
    CWRU Associate Professor
    Medical Director of Epilepsy 
    Department of Neurology
    MetroHealth Medical Center
    Cleveland, OH 

    Consulting Fees: LivaNova

    Ahmed Abdelmoity, MD
    Melva Dessenko O’Donnell Endowed Chair in Neurology
    Professor of Pediatrics UMKC
    Associate Chair, Department of Pediatrics
    Division Director, Neurology
    Children’s Mercy Kansas City
    Kansas City, MO 

    Consulting Fees: LivaNova

    Deborah Holder, MD
    Program Director, Epilepsy Fellowship
    Attending Physician, Division of Neurology
    Associate Professor of Neurology, Keck School of Medicine of USC
    Los Angeles, CA

    No disclosures reported.

    John Stern, MD
    Director, Epilepsy Clinical Program
    Director, Epilepsy Fellowship Program
    Co-Director, UCLA Seizure Disorder Center
    UCLA Department of Neurology
    Los Angeles, CA

    Consulting Fees: LivaNova, Neurelis, SK Life Science, Sunovion, UCB

    Reviewers/Content Planners/Authors:

    • Cindy Davidson has nothing to disclose.
    • Howard Green has nothing to disclose.
    • Kate Nagele has nothing to disclose.
    • Colleen Resnick has nothing to disclose.
    • Mario Trucillo, PhD, has nothing to disclose.
  • Learning Objectives

    After participating in this educational activity, participants should be better able to:

    • Describe the relationship between vagus nerve stimulation (VNS) titration speed and onset of clinical response in adult and pediatric patients with drug-resistant epilepsy (DRE)
    • Apply the most recent dosing and titration clinical data on VNS for adult and pediatric patients with DRE to optimize patient treatment plans
    • Recognize the impact of scheduled programming on clinical response in adult and pediatric patients undergoing VNS therapy
  • Target Audience

    This activity is designed to meet the educational needs of neurologists, pediatricians, nurse practitioners, and physician assistants.

  • Accreditation and Credit Designation Statements

    In support of improving patient care, Global Learning Collaborative (GLC) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

    Global Learning Collaborative (GLC) designates this enduring activity for a maximum of .25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Global Learning Collaborative (GLC) designates this activity for .25 nursing contact hours. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

    Global Learning Collaborative (GLC) has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for .25 AAPA Category 1 CME credits. Approval is valid until February 1, 2024. PAs should claim only the credit commensurate with the extent of their participation in the activity. 

  • Provider(s)/Educational Partner(s)

    Prova Education designs and executes continuing education founded on evidence-based medicine, clinical need, gap analysis, learner feedback, and more. Our mission is to serve as an inventive and relevant resource for clinical content and educational interventions across a broad spectrum of specialties. 

    Prova Education's methodology demonstrates a commitment to continuing medical education and the innovative assessment of its effects. Our goal is clear—to develop and deliver the very best education in the most impactful manner and to verify its results with progressive outcomes research.

  • Commercial Support

    This activity is supported by an independent educational grant from LivaNova PLC.

  • Disclaimer

    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of GLC and Prova Education. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience, and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to link to a site outside of Prova Education you are subject to the terms and conditions of use, including copyright and licensing restriction, of that site.

    Reproduction Prohibited
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