Vagus Nerve Stimulator (VNS)

Important information:

Some children have seizures which are difficult to control with medicine. For these children, a vagus nerve stimulator, or VNS, may help.

A VNS is an implanted medical device, like a pacemaker for heart patients. The generator is placed under the skin on the left side of the chest, in an area below the collarbone. It has wires that wrap around the vagus nerve inside the left side of the neck. These wires send signals to the brain to stop the seizure. This is used in addition to anti-seizure medicine to help decrease the number of seizures.

Benefits of vagus nerve stimulators include:

• Fewer seizures

• Shorter seizures

• Less severe seizures

• Improved alertness and quality of life

• Better seizure recovery

The vagus nerve stimulator works in two ways.

• The vagus nerve stimulator cannot detect seizures. Your child’s neurology provider will use a computer and wand to program the device to send stimulations throughout the day to the vagus nerve. This is the setting that aims to prevent seizures.   

• A magnet can be used to shorten a seizure. You will be provided with instructions on how and when to use it.

Instructions for using the magnet:

1. During an aura or seizure, place the magnet over the left chest area, where the generator is located.

2. Hold the magnet on the generator for 1 to 2 seconds and then remove it; or you can swipe the magnet downward over the generator for 1 to 2 seconds. This triggers an extra burst of stimulation to the vagus nerve that will last for 60 seconds.

3. If the seizure continues for a full minute, use the magnet again, the same way. This will send another 60 seconds of stimulation to the vagus nerve. If the seizure persists another 1 minute (for a total of 2 minutes) then you may use the magnet a third time.

4. If the seizure lasts 5 minutes despite the 3 magnet swipes, administer your child’s rescue medicine.

   • The VNS may or may not stop the seizure.

   • Do NOT use it more than once every 60 seconds.

   • You can use the VNS up to 3 times for one seizure.

Turning off the vagus nerve stimulator

If your child is having discomfort or pain with the stimulation, the VNS can be turned off. To turn the VNS off:

• Place the magnet over the stimulator in the left chest area.

• Tape the magnet to the chest.

• Contact the neurology office.

Restrictions

There are few restrictions for patients with a VNS. The device itself should not affect any working equipment such as microwaves or computers. However, the magnet can damage or inactivate some items. Be sure to keep the magnet away from:

• Electronic screens such as Computer or TV screens

• Bank cards or credit cards with magnetic strips

There are restrictions on the types of MRI your child can have once the VNS is placed. Please discuss this with your neurology provider. The generator must be turned off by your child’s neurology team if they receive an MRI.

Side effects

There are few side effects with a VNS. These are the most common side effects:

• Changes in voice

• Coughing

• Hoarseness

• Sore throat

• Neck pain

These mainly happen with stimulation and can be managed by your neurology provider who can adjust the settings.  

To learn more about VNS, talk to your child’s neurology team. You can also visit Epilepsy Foundation at www.epilepsy.com.

Contact your neurology team with questions or concerns.

Division of Neurology

215-590-1719

Ask to speak to your neurology nurse or provider. You may also send a message via MyCHOP for non-urgent questions.

Reviewed July 2024 by Susan Melamed, CRNP