A Patient Guide to Surgery
Introduction
If you have been recommended a vagal nerve stimulator (VNS) for conditions like epilepsy, treatment-resistant depression, or post-stroke neuroplasticity, you might be wondering what this procedure involves and how it could help. This guide explains what VNS is, how it works, what happens during surgery, and what to expect afterward.
At Endoscopic & Minimally Invasive Spine Specialists, we have extensive experience and expertise with vagal nerve stimulator surgery and provide the highest-quality care in surgical and non-surgical neurological care.
To learn more about vagal nerve stimulator implantation, call the office today or request an appointment online.
This guide will help you understand the condition, the procedure, its benefits, risks, and the recovery process.
What is VNS?
A vagal nerve stimulator is a small, implantable device that sends mild electrical pulses to the vagus nerve in your neck. The vagus nerve is a key part of your nervous system, connecting your brain to many organs and helping regulate things like mood, heart rate, and seizures. By stimulating this nerve, VNS can reduce seizure frequency in epilepsy or lift symptoms of severe depression when medications alone are not enough. It is FDA-approved and has been used for decades.
How Does It Work?
The VNS device delivers regular, gentle electrical pulses to the left vagus nerve (the right one is avoided to minimize heart effects). These pulses travel to the brain, subtly altering activity in areas linked to seizures or mood. For epilepsy, it can prevent or shorten seizures; for depression, it may improve mood over time. You can also get a magnet to swipe over the device during a seizure or low mood to trigger an extra pulse.
Who Qualifies?
VNS is typically for people whose epilepsy does not respond to drugs or who cannot have brain surgery, or for those with depression that persists despite multiple treatments. Your neurologist or psychiatrist will assess your history, symptoms, and overall health to see if VNS is an appropriate consideration for you.
The Surgery
VNS implantation is an outpatient procedure, usually lasting less than an hour under general anesthesia. The surgeon makes two small incisions: one in the left side of your neck (about 1-2 inches) to attach a thin wire to the vagus nerve, and another below your collarbone (about 2-3 inches) to place the generator device, which is about the size of a silver dollar. A wire under the skin connects the two devices. Stitches close the incisions, and patients go home the same day. You will need to avoid heavy lifting or neck strain for a couple of weeks to avoid straining the lead on your nerve or stretching the wounds that could dislodge the generator.
After Surgery
Recovery is straightforward—expect mild soreness or swelling for a few days. The device stays off for 1-2 weeks to let healing begin, then your doctor activates it in the office and adjusts the settings over several visits. You might feel a slight tickle or hoarseness when it pulses (every few minutes), but this typically fades away. Benefits build slowly: seizure reduction or mood improvement may take weeks to months. You will still take your medications unless advised otherwise by your neurologist or psychiatrist who referred you for treatment.
Benefits and Risks
VNS can cut seizure frequency by 50% or more and significantly boosts mood in depression. Side effects like hoarseness, coughing, or throat discomfort are usually mild and lessen over time. Rare risks include infection or nerve injury, but complications are uncommon.
Next Steps
Discuss VNS with your doctor to weigh its pros and cons for your situation. Ask about programming, magnet use, and follow-up care. It is a tool to manage—not cure—your condition, but it makes a big difference to your quality of life.
To learn how you can benefit from a vagal nerve stimulator and patient-centered care for your neurosurgical problems, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
