Daughter with Intractable Epilepsy and VNS

Hi!
My 10 year old daughter had viral encephalitis 4 years ago and has been left with Intractable Epilepsy. She just had the Vagal nerve stimulator implanted on June 5th and it is at .75 setting.  The vns seems to be helping already and I wanted to know if you have any  experience with the vagal nerve stimulator controlling sub-clinical seizure activity?  She has many little seizures at night-time without a clinical presentation and I was wondering if the vns has ever been attributed to a eeg showing marked improvement with sub-clinical activity?  She is also on 3 anticonvulsants, mysoline, Keppra and tegretol. Mysoline and Keppra are at theraputic levels and tegretol is being weaned slowly and is at a blood level of 3.  I would like to also know if you  believe that the 3 anticonvulsants have a effect on her cognition and clarity? She was having about 15 seizures a month and since the vns she only had 5 seizures in June and only 3 in July so far.
We have traveled to the Cleveland Clinic twice and she has been in the Epilepsy monitoring unit at the CCF twice and both times I was very pleased with the great care she received there.
                      Thank-You
                      Mom to 3

[CCF-Neuro-M.D.-CS]

I am very happy to hear that your daughter has done well with the VNS. The good response she has had thus far is encouraging, and there may be continued improvement over the next 12-18 months. There is no reason not to suspect that the VNS is also helping with the sub-clinical seizures, but without EEG monitoring there is no way to be sure.

The cognition issue is difficult. Frequent seizures or the anti-epileptics could contribute to poor cognition. Hopefully with the weaning of Tegretol the cognition will improve. Otherwise, ask your doctor at the Cleveland Clinic, and I am sure they could come up with a plan.

Good Luck

[hhmmhh]

I have absence epilepsy with seizures that are entirely subclinical.  I can't drive until they are controlled and the medicine isn't working.  They want me to try VNS, but its not proven to work for that.  Let me know if you find out that it works.