Vagal nerve stimulator

What is a vagal nerve stimulator (VNS)?

A vagus nerve stimulator is a device that stimulates the vagus nerve. This stimulation is used to treat epilepsy and seizures. A small, battery-powered stimulator is implanted under the skin in the chest and connected by a wire to the vagus nerve, in the neck. Small electrical pulses can then be delivered to send signals to certain areas of the brain and adjusted as needed.

Vagal nerve stimulation is not a cure for epilepsy, but it’s a proven approach to decreasing the frequency and severity of seizures in patients who haven’t responded to medication. It is usually used in concert with anti-epileptic drugs.

Learn more about epilepsy

How is the stimulator implanted?

Implanting the stimulator, or generator, is a relatively quick, minimally invasive procedure. First, a small incision is made on the upper left side of your chest to insert the device. Then, a wire is run under your skin from the device to the left side of your neck, where another small incision is made to attach the wire to your left vagus nerve. Occasionally, the device is implanted elsewhere on the patient’s upper body.

The pulse generator can usually be activated within a few weeks of implantation, after the patient has recovered from this minor procedure.

How are the electrical pulses activated and controlled?

The device is programmed at the doctor’s office and, based on its settings, will stimulate the vagus nerve in regular cycles, most often a few minutes apart. The level and timing of the electrical pulses can be adjusted over time, based on the patient’s response.

The patient will also be given a small magnet, usually worn on a wristband, that can be swiped over the device to trigger stimulation if they sense the beginning of a seizure, or to pause stimulation during certain activities (like exercise or public speaking).

How long does the battery last?

The life of the battery depends on the frequency of stimulation — which means it varies from person to person, anywhere from a few years to 7 or more years. Your neurologist can give you a more accurate estimate, based on the settings for your device.

When it’s time to replace the battery, it can be done in a simple, same-day surgery.

Is the device removable?

Yes. While the generator and attached wire are designed to be permanent implants, they can be removed by your doctor if you experience an adverse reaction or decide not to continue with vagal nerve stimulation therapy.

Who is a good candidate for vagal nerve stimulation?

Vagal nerve stimulation is generally considered when anti-seizure medication has been ineffective in controlling a patient’s seizure frequency.

It can be an especially effective option for people whose seizures can’t be traced to a specific location in the brain, or whose seizures originate from multiple points in the brain, and therefore aren’t good candidates for more invasive surgery. Learn more about seizures

As always, you should talk to your neurologist about whether vagal nerve stimulation may be an effective approach for you.

How effective is it?

It’s important to remember that the goal of vagal nerve stimulation is not to cure epilepsy, but to reduce the frequency and severity of seizures. Though every person is different, and results can take a while to develop, some patients experience as much as 50% fewer seizures. Some also see a decrease in seizure intensity and recovery time after a seizure.

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