Who Is a Candidate for Vagus Nerve Stimulation When Seizures Resist Medication?

The pharmacy bag on the kitchen counter has been swapped out so many times that the family has stopped reading the labels closely. A new medicine, a few hopeful months, then the same morning routine: a seizure in the shower, a missed shift, a partner quietly checking the clock. Somewhere in that cycle a neurologist says the phrase that changes the conversation: drug-resistant epilepsy. Then, almost in the same breath, a question people rarely expect to be asking about themselves: who is a candidate for VNS?

Vagus nerve stimulation sits in an odd place in the public imagination. It sounds like science fiction and is often described as a last resort, yet it has been used in epilepsy care for decades and involves no operation on the brain itself. The real puzzle for patients is not whether the technology exists but whether it fits their situation.

This explainer walks through what epilepsy teams actually weigh: how many medicines have been tried, what kind of seizures are happening, what the heart and airway look like, and what a realistic outcome is. The decision always stays with the treating team, but understanding the criteria makes that conversation far less intimidating.

How vagus nerve stimulation actually works

The vagus nerve is the longest of the cranial nerves, a pair of cables that run from the brainstem down each side of the neck into the chest and abdomen. Most of its fibers carry information toward the brain rather than away from it, which is exactly why it interests epilepsy specialists: it is a natural highway into deep brain structures without opening the skull.

Vagus nerve stimulation, or VNS, uses that highway. A surgeon places a small pulse generator, roughly the size of a large coin, under the skin of the upper left chest. A thin insulated wire runs under the skin to the neck, where its tip is wrapped around the left vagus nerve. The left side is chosen deliberately: the right vagus nerve sends more branches to the heart, so stimulating it carries a higher risk of slowing the heart rate, as Mayo Clinic’s procedure overview explains.

Once switched on, the generator delivers mild electrical pulses on a fixed cycle, typically a burst lasting seconds followed by a rest lasting minutes, around the clock. Those pulses travel up to a brainstem relay station and from there to regions involved in arousal, mood and seizure threshold. The precise mechanism is still debated. Current thinking, summarized by Johns Hopkins and Cleveland Clinic, is that regular stimulation gradually changes how excitable seizure-prone networks are and alters the release of chemical messengers such as norepinephrine.

Two practical features follow from this design. First, VNS is adjunctive: it is added to medicines, not swapped for them. Second, the person or a caregiver carries a small magnet that, swiped over the generator, triggers an extra burst of stimulation. Some people use it when they feel a seizure beginning, and some newer generators can also respond automatically to a sudden rise in heart rate that often accompanies a seizure.

Who is a candidate for VNS? Start with drug-resistant epilepsy

Every conversation about candidacy begins with one clinical label. The International League Against Epilepsy defines drug-resistant epilepsy as the failure of two anti-seizure medicine schedules that were appropriately chosen, adequately used and reasonably tolerated, whether tried one after another or in combination. That definition, published in the journal Epilepsia and used by the NHS and major U.S. centers, is the gatekeeper for nearly every non-drug epilepsy therapy, VNS included.

Why two medicines rather than five or ten? The answer comes from a landmark study of 470 people with newly diagnosed epilepsy, published in the New England Journal of Medicine and listed in the references. About 47 percent became seizure-free on their first medicine. Of those who did not, roughly 13 percent responded to a second. Only about 4 percent responded to a third medicine or a combination. Put simply, once two suitable medicines have failed, the odds that the next one will bring full control drop sharply, and continuing to cycle through prescriptions carries its own costs in side effects and lost years.

The phrase appropriately chosen matters as much as the number. A medicine that was never a good match for the seizure type, or that was stopped after a few days because of a rash, does not count as a fair trial. Neither does a medicine that was taken erratically. Part of the evaluation is a careful audit of what has actually been tried, at what strength, and for how long, which is why bringing a complete medication history to an epilepsy clinic is one of the most useful things a person can do.

Meeting this definition does not make VNS automatic. It opens the door to a broader evaluation, described later, in which the team asks whether a different intervention might offer more.

What qualifies you for VNS: seizure types and syndromes

Regulatory approval in the United States covers VNS as an add-on therapy for focal onset seizures, meaning seizures that begin in one area of the brain, in people aged four and older whose seizures have not responded to medicines. Cleveland Clinic and Johns Hopkins both describe this indication in their patient guides. Focal seizures are the most common type in adults and include events once called partial seizures, with or without loss of awareness.

Clinical practice has moved beyond that narrow label. The American Academy of Neurology guideline update on VNS, listed in the references, reviewed evidence in children and in people with Lennox-Gastaut syndrome, a severe childhood-onset epilepsy with multiple seizure types, and concluded that VNS may be considered in both groups. Many epilepsy centers also offer VNS to adults with generalized seizures, which involve both sides of the brain from the start, when medicines have failed and no single seizure focus can be found.

A few patterns tend to make a person a more natural fit:

• Seizures arising from more than one region, or from a region that cannot be safely removed, so that resective surgery is not an option.
• Multiple seizure types in the same person, as in Lennox-Gastaut syndrome.
• A previous brain operation that helped but did not fully control seizures.
• A strong preference to avoid brain surgery after a full discussion of alternatives.

Conversely, someone whose seizures are already well controlled on medicine, even if they dislike taking it, is not a candidate. VNS does not exist to replace medication; the evidence base is built entirely on people who kept taking their prescribed treatment.

The same device is also approved for treatment-resistant depression under separate criteria. That indication is evaluated by psychiatry rather than epilepsy teams and is outside the scope of this article.

Is VNS an option for children with hard-to-control seizures?

Parents often assume neurostimulation is an adult treatment. In fact, some of the strongest guideline language concerns children. The American Academy of Neurology update pooled data from 470 children treated with VNS and found that about 55 percent had their seizure frequency cut by at least half, a figure the guideline authors rated as evidence that VNS may be effective in pediatric epilepsy. The same review found that the benefit in children with Lennox-Gastaut syndrome was similar to that in other groups.

The pathway for a child mirrors the adult one: confirmation of drug-resistant epilepsy, video-EEG monitoring to characterize the seizures, brain imaging, and a multidisciplinary meeting where surgery to remove seizure tissue is considered first if a clear focus exists. Where no such focus exists, or where removing it would risk speech, movement or vision, VNS moves up the list.

A few points are specific to younger patients. Growth matters: surgeons leave a small loop of slack in the lead so it can accommodate a lengthening neck, and follow-up visits check that the wire is not under tension. Comfort and communication matter too. A child who cannot describe throat tingling or a hoarse voice needs caregivers who know what stimulation feels like and can watch for signs of discomfort during the adjustment period. Schools and after-school programs usually need a short written plan explaining the magnet, what a caregiver should do during a seizure, and who to call.

Families also ask about mood and alertness. Several observational studies have reported improved alertness in some children, but the guideline authors were cautious, noting the evidence for those secondary benefits is weaker than the evidence on seizure counts. Honest counseling frames VNS as a tool that may reduce seizure burden, not a treatment that will transform development.

Who is not a candidate for VNS, and who is usually asked to wait

The clearest exclusions relate to the nerve itself and to the heart. A person who has had a left cervical vagotomy, an operation in which the left vagus nerve in the neck was deliberately cut, has no intact nerve to stimulate, and Cleveland Clinic lists this as a reason VNS cannot be offered. A history of significant heart rhythm disturbances or conduction block prompts a cardiology review before any decision, because stimulation can occasionally slow the heart, particularly during the operation itself.

Obstructive sleep apnea, a condition in which the airway repeatedly narrows during sleep, deserves special mention. Mayo Clinic notes that VNS can worsen sleep apnea, so people with known or suspected apnea are often asked to have a sleep study first and to have the condition treated before implantation.

Other situations lead teams to say not yet rather than never:

• Fewer than two adequate medicine trials, or trials the team cannot verify.
• An uncertain diagnosis, especially when some events might be non-epileptic seizures, which are real and disabling but do not respond to electrical stimulation.
• A seizure focus that imaging and EEG suggest could be removed with a good chance of seizure freedom. Guidelines and the NHS both favor resective surgery in that situation because it offers something VNS rarely does: the possibility of stopping seizures entirely.
• Active infection anywhere in the body, which raises the risk of the implant becoming infected.
• Inability to attend the follow-up visits needed to adjust the device over the first year.

Pregnancy is handled case by case; there is no absolute bar, but most teams prefer to complete implantation and initial programming outside of pregnancy when the timing allows.

One more soft exclusion is worth naming plainly. A person who expects VNS to end their seizures, and who would view anything less as failure, may be better served by more counseling before surgery than by the surgery itself.

How VNS compares with other options after medicines fail

Drug-resistant epilepsy opens several doors at once, and candidacy for VNS is partly defined by whether another door is a better fit. The table below summarizes the main non-drug pathways that epilepsy centers typically discuss, drawing on descriptions from the NHS, Mayo Clinic and Cleveland Clinic. It is a map, not a ranking; the right route depends on where seizures start, what tissue can be spared, and what the person values.

Option	Who it usually suits	What it involves	What it aims for
Resective brain surgery	A single, well-localized seizure focus in tissue that can be removed safely	Operation on the brain under general anesthesia; days in hospital	Seizure freedom is a realistic goal for well-selected people
Vagus nerve stimulation	No removable focus, multiple foci, generalized seizures, or a preference to avoid brain surgery	Generator in chest, lead on left vagus nerve; no skull opening; usually same-day or overnight stay	Fewer, shorter or milder seizures; seizure freedom uncommon
Responsive or deep brain stimulation	Focal seizures from areas that cannot be removed, or two foci	Electrodes placed in or on the brain connected to a generator	Reduction in seizure frequency that tends to grow over time
Dietary therapy (ketogenic and related diets)	Often children; some adults; certain metabolic epilepsies	Medically supervised high-fat, very low-carbohydrate eating plan	Reduced seizures in a proportion of people; requires strict adherence

Two contrasts drive most decisions. Against resective surgery, VNS trades a lower ceiling of benefit for a much smaller procedure and no risk to brain tissue. Against other neurostimulation, VNS avoids intracranial electrodes but offers less targeted stimulation. Dietary therapy can be combined with any of these.

None of these routes replaces medication in the short term. Most people continue their prescribed regimen through and after the procedure, and any later change is a decision for the prescribing clinician based on how seizures behave over the following year or more.

How to qualify for vagus nerve stimulation: what the evaluation involves

People sometimes ask how to qualify as though there were a form to complete. The reality is an evaluation designed to answer three questions: are these definitely epileptic seizures, where do they come from, and is there a better option than VNS? Most of it happens at a comprehensive epilepsy center, and it follows a fairly predictable sequence described by Johns Hopkins and Mayo Clinic.

Video-EEG monitoring comes first. EEG, or electroencephalography, records the brain’s electrical activity through scalp electrodes; pairing it with continuous video over several days lets the team see and measure actual seizures rather than rely on descriptions. This step frequently changes the diagnosis: it can reveal non-epileptic events, reclassify focal seizures as generalized, or locate a focus no one suspected.

High-resolution MRI of the brain follows, looking for scars, malformations or tumors that might be surgically removable. If MRI and EEG disagree, additional scans that map blood flow or metabolism, such as PET or SPECT, may be added. Neuropsychological testing, a set of structured tasks assessing memory, language and attention, helps predict what surgery on a given region might cost and provides a baseline for later comparison.

Alongside the brain work-up, the team looks at the rest of the body. An electrocardiogram screens for rhythm problems. A sleep history, and often a sleep study, checks for obstructive sleep apnea. Anesthesia staff review general health.

Then comes the multidisciplinary conference. Epileptologists, neurosurgeons, neuropsychologists and nurses review everything together and reach a recommendation, which is then discussed with the patient and family. The NHS describes this shared decision as the point where surgery, stimulation or continued medical management is chosen. Someone who leaves that meeting with a VNS recommendation has, in effect, qualified; someone who leaves with a recommendation for resective surgery has been offered something the team believes may do more.

What benefit VNS realistically offers, in guideline language

Honesty here matters more than enthusiasm, because expectations shape how people judge the result. The American Academy of Neurology guideline update, the most cited independent summary, described three findings that every candidate should hear.

First, response is partial for most people. The standard research yardstick is a 50 percent or greater reduction in seizure frequency. Across the studies reviewed, roughly half of treated people reached that threshold, with the pooled pediatric figure at about 55 percent. Complete seizure freedom occurred in a small minority and should not be the goal against which the treatment is measured.

Second, benefit builds slowly. The guideline reported that the proportion of people reaching a 50 percent reduction rose by around 7 percentage points between one and five years after implantation. In practice this means that a disappointing first few months do not settle the question, and that teams generally want a full year of adjusted stimulation before drawing conclusions.

Third, there are no reliable predictors of who will respond. Age, seizure type, duration of epilepsy and prior surgery have all been examined; none separates responders from non-responders with confidence. That uncertainty is why the decision is framed as a reasonable trial of an add-on therapy rather than a guaranteed step.

Beyond counting seizures, people and families often describe changes the trials measured less rigorously: seizures that are shorter, recovery afterward that is faster, fewer emergency visits, and for some, a steadier mood or clearer alertness. Mayo Clinic and Johns Hopkins note these reports while cautioning that the evidence for them is weaker. A fair summary is that VNS is one of several tools for reducing seizure burden when medicines alone have not done enough, and that its value emerges over years rather than weeks.

What happens on surgery day and in the weeks that follow

The operation itself is smaller than most people imagine. It is done under general anesthesia and, according to Mayo Clinic’s overview, typically takes about an hour to an hour and a half. The surgeon makes one incision on the left side of the neck to expose the vagus nerve and wrap the electrode around it, and a second incision on the upper left chest to create a pocket for the generator. The lead is tunneled under the skin between the two. Nothing enters the skull. Many people go home the same day or after one night.

Soreness at both incisions and a stiff neck are expected for a week or two. Most surgeons ask people to avoid heavy lifting and vigorous neck movement while the wounds heal and to keep the incisions clean and dry as instructed. Regular medicines continue unchanged.

The device is usually left switched off at first. Mayo Clinic notes it is typically turned on during an outpatient visit a few weeks after surgery, once the incisions have healed. Programming is done wirelessly with a wand held over the chest; there are no injections and no further surgery. The initial setting is deliberately low so the person can get used to the sensation, which is often described as a tickle or tightness in the throat and a change in voice during each burst.

Over the following months, the team raises the stimulation in small steps at successive visits, watching seizure diaries and side effects. Cleveland Clinic describes this adjustment period as lasting several months, and the guideline evidence suggests benefit can continue to accrue for years after that. Between visits, the person or caregiver practices using the magnet, both to trigger an extra burst when a seizure starts and, held in place, to pause stimulation temporarily if it becomes uncomfortable, for example while singing or public speaking.

Side effects, risks and who should avoid vagus nerve stimulation

Because the vagus nerve also serves the voice box, throat and airway, the most common side effects are exactly what anatomy would predict. The American Academy of Neurology guideline lists hoarseness or voice change, cough, throat pain or tingling, and a sensation of shortness of breath as the most frequently reported effects. They occur while the device is actively stimulating, so they come and go on the cycle, and the guideline notes they tend to lessen over time and with adjustment of settings.

Surgical risks are those of any implant. Infection at either incision is the most important, because an infected device sometimes has to be removed; meticulous wound care in the first weeks is the main defense. Damage to the nerve during placement can cause a weak or paralyzed vocal cord, usually temporary but occasionally lasting. Over years, the lead can fracture or the generator can migrate, each requiring a revision procedure. Slowing of the heart during the operation has been described and is one reason cardiac screening is routine.

Two groups should approach VNS with particular caution or avoid it:

• People with untreated obstructive sleep apnea, since stimulation can increase the number of breathing pauses during sleep, as Mayo Clinic notes.
• People with significant heart conduction disease, unless a cardiologist has reviewed the plan.

Less common effects include difficulty swallowing, neck pain, headache and, in some people, increased snoring. Swallowing changes matter most in those already at risk of aspiration, such as some children with severe neurological impairment, and teams weigh this individually.

Every side effect discussed here can be reduced by lowering stimulation or, if needed, switching the device off, which is one of the reassurances people find most useful: unlike resective surgery, VNS is adjustable and reversible in its effects even though the hardware stays in place.

Living with a VNS device: MRI, magnets, batteries and daily life

Once healed, the implant fades into the background for most people, but a handful of practical rules follow it for life. The first concerns MRI. Modern VNS systems are labeled MRI conditional, meaning scans are possible only under specific conditions: particular scanner strengths, specific coils, and the device programmed off beforehand. Every clinician who orders imaging needs to know the device is there. Cleveland Clinic and Mayo Clinic both advise carrying the implant identification card and telling dentists and physical therapists too, since shortwave diathermy, a deep-heat physical therapy treatment, is not compatible with the implant.

Magnets deserve a moment of clarity because they play two roles. The prescribed handheld magnet, swiped over the chest, delivers an extra stimulation; held over the generator, it pauses stimulation. Other strong magnets, such as those in some speakers or industrial equipment, can do the same thing unintentionally if held against the chest. Everyday exposures, including airport security arches, mobile phones and kitchen appliances, are not considered a problem.

The generator runs on a sealed battery that lasts several years, with the exact life depending on settings. Follow-up visits track remaining charge, and replacement is a short procedure through the chest incision alone; the lead around the nerve usually stays in place.

Driving rules do not change because of the device. Licensing depends on seizure control and local law, and the NHS and state authorities set those rules independently of how seizures are treated. Sports and exercise are generally fine after healing, with contact to the chest and neck area a reasonable thing to discuss with the team.

A seizure diary, whether on paper or an app, is the single most useful habit. It turns the vague sense that things seem a bit better into data the team can use when deciding how, and whether, to adjust stimulation.

What people often get wrong about VNS

Misunderstandings cluster around a few ideas, and each one can distort the decision.

It is brain surgery. It is not. The electrode sits on a nerve in the neck and the generator under the skin of the chest. No part of the operation touches the brain, which is precisely why it is offered to people for whom brain surgery is unsuitable.

It replaces medicine. Every study behind the guidelines added VNS to ongoing medication. Some people are later able to simplify their regimen, but that is a decision made by the prescriber over time, never an assumption at the outset.

It works right away. The guideline data show response improving over years, not weeks. Judging VNS at three months is like judging a garden the week after planting.

The magnet stops every seizure. The magnet delivers an extra burst that some people find shortens or softens a seizure. It is a useful tool, not an off switch.

Anyone with epilepsy can have one. Candidacy depends on documented drug resistance, a confirmed diagnosis, and a team judgment that no better option exists.

Last resort means end of the road. VNS is often offered before, alongside or after other options such as dietary therapy or newer medicines, and non-responders can still be reconsidered for other neurostimulation.

Consumer gadgets that stimulate the ear or neck are the same thing. Devices marketed as non-invasive vagus nerve stimulators are a different technology. Some have regulatory clearance for headache conditions, but there is no guideline-level evidence that they control epileptic seizures, and they should not be treated as a substitute for evaluation at an epilepsy center.

Understanding these distinctions tends to make people better partners in the decision, and less likely to feel misled later.

Questions to ask your care team before deciding

A good consultation about VNS is a two-way exchange, and the most useful questions are the ones that reveal how the team sees your particular case rather than the therapy in general. Bring a companion if you can; people remember more when two sets of ears are in the room.

• Which anti-seizure medicines do you count as adequate trials in my history, and are there any you think were never properly tested?
• Did my video-EEG and MRI show a single seizure focus, and if so, why is VNS being recommended over surgery to remove it?
• Have I been screened for sleep apnea and heart rhythm problems, and do the results change anything?
• Based on the guidelines, what range of seizure reduction would you consider a good result for someone like me, and how long will you wait before judging it?
• What will the first year look like in terms of visits and adjustments, and who do I contact between visits?
• Which side effects should I expect during stimulation, and what happens if I cannot tolerate them?
• How will my medicines be managed after implantation, and who decides on any changes?
• What are the rules about MRI, other medical procedures and the magnet that I need to pass on to other clinicians?
• If VNS does not help enough, what would the next options be?
• Is there a clinical nurse specialist or coordinator who can walk my family or school through the magnet and seizure plan?

Write down the answers. Recommendations can look different a week later, and the notes will also help if you seek a second opinion, which reputable teams welcome for a decision of this kind.

When to call your doctor

Some situations after VNS surgery, or during life with the device, need a same-day call to the epilepsy team or, in a few cases, emergency services.

Call emergency services for any seizure that lasts longer than five minutes, for seizures that follow one another without recovery in between, for a seizure in water, for a first-ever seizure, or for any seizure followed by difficulty breathing, serious injury or failure to wake. The five-minute threshold is the standard used by the CDC and the NHS to define a seizure emergency, and it does not change because a person has a stimulator.

Contact the surgical or epilepsy team promptly for:

• Redness, swelling, warmth, increasing pain or discharge at either incision, or a fever in the weeks after surgery. These may signal infection, which is treated most easily when caught early.
• Sudden difficulty breathing or swallowing, or hoarseness that is severe, constant or getting worse rather than pulsing with the stimulation cycle.
• Fainting, palpitations or a noticeably slow or irregular heartbeat.
• Stimulation that suddenly feels painful, much stronger, or stops being felt altogether, or a sensation of electric shocks in the neck. These can indicate a lead problem.
• New snoring, gasping in sleep or unusual daytime sleepiness, which may point to worsening sleep apnea.
• A clear increase in seizure frequency or a new seizure type.

Between these extremes, ordinary questions about voice change, coughing during stimulation or how to use the magnet are exactly what the follow-up visits and the team’s contact line are for. Nobody should feel they have to wait for the next scheduled appointment to raise them, and no adjustment to the device or to medicines should ever be attempted at home.

Frequently asked questions

What qualifies you for VNS?

The core qualification is drug-resistant epilepsy: seizures that persist despite adequate trials of at least two suitable, well-tolerated anti-seizure medicines. Teams then confirm the seizures are epileptic with video-EEG, check imaging for a removable focus, and screen the heart and airway. If no better option exists and the person understands the likely partial benefit, VNS may be recommended.

Who is not a candidate for VNS?

People whose left vagus nerve has been surgically cut, those with significant untreated heart rhythm or conduction disease, and those with untreated obstructive sleep apnea are generally not offered VNS until those issues are addressed. Others are steered elsewhere: people with a single removable seizure focus are usually offered resective surgery first, and those whose events are non-epileptic will not benefit.

How do you qualify for vagus nerve stimulation?

There is no application; qualification happens through a comprehensive epilepsy evaluation. That typically includes video-EEG monitoring to record actual seizures, brain MRI, sometimes PET or SPECT scans, neuropsychological testing, an electrocardiogram and a sleep assessment. A multidisciplinary team then reviews everything and recommends surgery, stimulation or continued medical treatment, discussed with the patient before any decision.

Who should avoid vagus nerve stimulation?

People with untreated sleep apnea should avoid VNS until the apnea is managed, because stimulation can worsen breathing pauses during sleep. Those with serious heart conduction problems need cardiology clearance first. Anyone with an active infection should wait, and anyone unable to attend the follow-up visits needed to adjust the device over the first year is unlikely to gain its full benefit.

What are the vagus nerve stimulation contraindications listed by clinics?

Clinic guides list a prior left cervical vagotomy as an absolute barrier, and treat significant cardiac arrhythmias, obstructive sleep apnea and active infection as conditions to resolve or review before surgery. After implantation, shortwave diathermy is not permitted, and MRI is allowed only under specific conditions with the device switched off, which is why all clinicians must know the implant is present.

Is VNS considered brain surgery?

No. The procedure involves two small incisions, one in the neck to wrap an electrode around the vagus nerve and one in the upper chest for the generator. The skull is never opened and no instrument touches the brain. This is a central reason VNS is offered to people whose seizures cannot be treated safely with surgery on brain tissue.

Can I stop my epilepsy medicines after VNS?

Not on your own, and usually not soon. VNS was studied and approved as an add-on to ongoing medication, and guideline evidence shows its benefit builds over years. Some people are later able to simplify their regimen, but that decision belongs to the prescribing clinician, guided by seizure diaries and follow-up over at least a year of adjusted stimulation.

How long does it take for VNS to work?

Longer than most people expect. The device is usually switched on a few weeks after surgery and adjusted upward over several months. The American Academy of Neurology guideline found that the share of people achieving a 50 percent seizure reduction increased by about 7 percentage points between one and five years, so teams generally wait at least a year before judging the result.

What are the VNS criteria for epilepsy in children?

Children are evaluated with the same steps as adults: confirmation of drug-resistant epilepsy, video-EEG, imaging and a team review that considers resective surgery first. Regulatory approval covers focal seizures from age four, and guideline evidence supports considering VNS in children generally and in Lennox-Gastaut syndrome. Growth, comfort and caregiver training with the magnet are specific pediatric considerations.

Can I have an MRI with a VNS device?

Often yes, but only under specific conditions. VNS systems are labeled MRI conditional, meaning scans are permitted with certain scanner strengths and coil types and with the device programmed off beforehand by the epilepsy team. Anyone ordering imaging must know about the implant, so carrying the device identification card and informing every clinician is essential.

References

• Cleveland Clinic: Vagus Nerve Stimulation (VNS)
• NHS: Epilepsy, Treatment

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.