Deep Brain Stimulation vs. Vagus Nerve Stimulation for Epileptic Spasms

Inclusion Criteria: * Female or Male patients 5 years of age and over (17 and 11 months), not including 18 years old * Diagnosis of drug-resistant epilepsy with failure after trial of two anti-epileptic * Medications (as defined by Kwan et al. 20093). All children screened for entry into the study will be re-diagnosed by a neurologist prior to entry. * Main seizure type includes epileptic spasms and tonic spasms, as confirmed by electroencephalography. * Parents or legal guardians, including caregivers, are informed and able to give written consent. * Ability to comply with all testing, follow-ups and study appointments and protocols for 12 months following the end of the duration of the study Exclusion Criteria: * Substance dependence or abuse in the last 6 months, excluding caffeine and nicotine * Any contraindication to MRI scanning. A preoperative MRI scan is essential to * Planning DBS and therefore any contraindication to MRI is a contraindication to enrollment in the study. * Unwillingness or inability to return to SickKids for follow-up visits. * Presence of cardiac arrhythmias, or other cardiac, respiratory, renal or endocrine conditions that will result in significant risk from a surgical procedure. * Pregnancy * Inability to communicate adequately in English in order to complete the baseline and follow-up questionnaires. * A co-morbid condition that requires frequent MRI scanning as part of the patient's regular care.