Specialist Stimulation Treatment
Vagus Nerve Stimulation
Vagus nerve stimulation, or VNS, is an implanted treatment that may help some people with drug-resistant epilepsy reduce seizures. It is usually used alongside medication.
About this information: This webpage is subject to continuous review by Epilepsy South Central Ontario to help keep the information current. This material is for informational purposes only and should not be used for self-diagnosis or as a substitute for professional medical advice, diagnosis or treatment. Consult your healthcare provider about your own health and care.
Follow the instructions for your particular device and treatment plan. Do not change medication or device use based on a general webpage.
Understanding the Device
What is VNS?
A small generator is implanted under the skin of the chest. A lead connects it to the vagus nerve in the neck, allowing it to deliver electrical stimulation at programmed intervals.
The stimulation reaches brain networks through the nerve. VNS implantation does not involve removing seizure-generating brain tissue.
Who may be a candidate?
A specialist epilepsy team may consider VNS when seizures remain uncontrolled despite appropriate treatment, including when resective surgery is unsuitable or has not provided sufficient benefit.
Suitability depends on the person’s epilepsy, other health conditions, treatment history and the specific device’s indications.
What does assessment involve?
The team reviews your diagnosis, seizures, previous treatments and possible alternatives. Tell them about breathing or swallowing problems, sleep apnoea, heart conditions and other implanted devices.
Ask the treating centre to confirm referral requirements, eligibility, coverage and any related costs.
Implantation, Programming & Follow-Up
Implantation requires surgery and an anaesthetic plan. Your surgical team will explain preparation, recovery, wound care and possible complications.
The clinical team programs the device and adjusts settings over time according to response and tolerability. There is no single setting or adjustment schedule appropriate for everyone.
Ongoing follow-up includes checking the system and planning for battery replacement or other device care.
Set Realistic Expectations
What Benefits Can I Expect?
Benefits vary.
Some people experience fewer, shorter or less severe seizures, easier recovery or improved quality of life. Improvement may develop over time, and some people benefit more than others.
Ask your team how progress will be measured and when treatment will be reviewed.
VNS is not a guaranteed cure.
Seizures may continue. Keep following your prescribed medication schedule, safety advice and seizure action plan.
Any medication changes must be directed by your prescriber.
Safety & Everyday Life
What Do I Need to Know?
Side effects
Stimulation may cause voice changes or hoarseness, cough, throat discomfort or shortness of breath. Implantation also carries surgical risks, including infection.
Report symptoms to your team. Settings may need review. Seek urgent care for serious breathing or swallowing difficulty, and call 911 for an emergency.
Magnet use
Some VNS systems use a supplied magnet to start additional stimulation or temporarily stop stimulation. These are different actions.
Use the magnet only as taught by your VNS team. Do not improvise instructions or assume it will stop every seizure.
MRI scans
MRI may be possible only under specified conditions that depend on the device model, implant location and scan requirements.
Tell the MRI centre about the device before booking and coordinate with your VNS team. Do not take the patient magnet into the MRI scanner room.
Other procedures & equipment
Tell medical, dental and therapy providers that you have an implanted VNS system before treatment. Some procedures, including certain forms of diathermy, are contraindicated.
Carry device identification and use the manufacturer’s current instructions for your model.
VNS does not replace seizure first aid.
Follow the person’s seizure action plan. Use the magnet or prescribed rescue medication only if instructed and trained. Get emergency help when indicated, even if the magnet has been used.
Questions for Your Epilepsy Team
- Why might VNS be appropriate for me?
- Have other surgical or non-drug options been considered?
- What benefits and risks are realistic in my situation?
- How often will I need programming and follow-up?
- What exactly should I and my caregivers do with the magnet?
- What should I do before an MRI or another medical procedure?
- Who do I contact about device concerns, and when is it an emergency?
- What coverage, travel and future replacement arrangements should I confirm?
Device-Specific Resources
The links below are from the device manufacturer and provide Canadian patient information. They are not a substitute for instructions from your treating team.
Existing Video Resources
Learn More About VNS
These videos are retained from the original page. Device features and advice may vary; confirm what applies to your model and treatment plan.