Vagus Nerve Stimulation

If you have epilepsy or treatment-resistant depression, vagus nerve stimulation (VNS) may be an option to help relieve your symptoms.

Vagus nerves are cranial nerves that start in the brain and extend through the neck to both sides of the chest and abdomen. These important nerves carry messages from the brain to other parts of the body to control involuntary motor and sensory functions.

During VNS, mild electrical pulses are delivered from the left vagus nerve to the brain using a pacemaker-like stimulator and wires that are placed under the skin in the chest.

For people with seizures, VNS may lessen the number, length and severity of the seizures and also help with recovery. People with treatment-resistant depression (depression that doesn’t respond to standard treatment) may see an improvement of symptoms with time after using VNS.

The U.S. Food and Drug Administration (FDA) approved VNS as a treatment for patients who tried two or more medications for seizure control with no success. The FDA also approved VNS for patients with severe, chronic depression that has failed to respond to four or more treatments.

Before Vagus Nerve Stimulation

Before recommending VNS for treatment, a physician with specialized training will ensure you are an ideal candidate for the procedure. Some health conditions that may disqualify you for VNS include heart arrhythmias, lung disease, ulcers, pre-existing hoarseness and having only one vagus nerve. You also cannot have VNS if you are receiving another form of brain stimulation.

During Vagus Nerve Stimulation

VNS is an outpatient procedure that usually takes 45–90 minutes. Before implantation, you will be given general anesthesia so you do not feel pain or have memory of the procedure. Your neurosurgeon will make a small horizontal incision on the left side of the lower neck. A flat, round piece of metal called a pulse generator will be implanted into the chest. The pulse generator is attached to the vagus nerve with thin wires leading into the neck. Most patients will not feel pain or other sensations from the device.

After Vagus Nerve Stimulation

Your stimulator will either be activated immediately or within a few weeks of the procedure. You will be given a handheld magnet to control the device at home. The neurology team will give you instructions for when you should use it to temporarily deactivate the device.

You’ll continue to have regular appointments with your physician to make sure your pulse generator is held securely in place and working correctly. A physician will also guide you on what medications to take in addition to VNS. If you experience any complications, such as painful stimulation or a constantly hoarse voice, call your doctor right away. In addition, call your physician before having any medical tests that can affect VNS, such as implantation of another device or an MRI.

Remember to have patience. It can take several months to a few years to see improvement after VNS therapy. But the good news is that studies show many patients see significant improvements with time.