Vagus Nerve Stimulation (VNS)

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Vagus nerve stimulation (VNS), a type of neuromodulation, may be recommended to treat epilepsy if your seizures are not controlled by medications and you are not a candidate for other types of epilepsy surgery. VNS is FDA-approved for adults and children as young as four years old. 

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About Vagus Nerve Stimulation

A vagus nerve stimulator activates a segment of the vagus nerve, which connects to areas in the brain involved in seizures. The device delivers scheduled electrical impulses through the vagus nerve and onto the brain to reduce the likelihood and severity of seizure events.

A VNS consists of a generator, or battery, and an electrode. The generator is implanted in your or your child’s chest below the left collarbone; it is connected to the vagus nerve through an electrode that is placed under the skin in the left side of your neck. 

In addition to delivering regularly scheduled stimulation to deter seizure activity overall, you can also disrupt an oncoming seizure by waving a special magnet over the device to activate it. Some VNS devices can also automatically deliver stimulation if they detect a rapid increase in heart rate (which often signals the start of an epileptic seizure).

VNS is more effective over time, reducing the number of seizures by approximately half.1 Research shows VNS can also reduce the length and severity of seizures, as well as recovery time after a seizure event. 

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Duke Health offers locations throughout the Triangle. Find one near you.

VNS Placement Procedure

Before the surgery to place your RNS device, you will undergo a thorough epilepsy evaluation to pinpoint the area in your brain where seizures begin. 

During the placement procedure, a neurosurgeon makes two small incisions. The VNS generator is placed in the upper left chest, and the electrode is placed in the left side of the neck. A wire, which runs under the skin, connects the generator to the electrode. The device cannot be seen outside your body. 

The procedure takes about two hours, and it usually does not require an overnight stay in the hospital. Full recovery takes about four to six weeks.

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VNS Activation and Programming

The device will be turned on and programed by a neurologist about two weeks after the procedure. 

Over the next few months, a neurologist will fine-tune the device settings to maximize benefit and minimize side effects. People usually begin noticing fewer seizures within three to six months. Side effects include temporary hoarseness, shortness of breath, coughing, and sore throat while the device is sending electrical impulses.

Doctors usually recommend continuing epilepsy medications in addition to VNS.

Level 4 Epilepsy Center - Adult

As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical, and surgical treatments for people with epilepsy. It is one of the reasons why Duke University Hospital’s neurology and neurosurgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report in 2023-2024.

Battery Change Procedures

VNS batteries need to be changed every three to six years, on average. This requires a short outpatient procedure.

This page was medically reviewed on 08/17/2023 by