How do I know if I’m a candidate for vagus nerve stimulation (VNS)?
VNS is primarily used for people whose epilepsy, depression, migraine, or cluster headaches aren’t responding sufficiently to medications, or for those who can’t tolerate medications. If you’re interested in VNS, discuss it with your doctor, says Kevin J. Tracey, MD, a neurosurgeon and president of the Feinstein Institutes for Medical Research at Northwell Health in Manhasset, NY.

Do I need to be a certain age to be eligible for VNS?
It depends on the condition being treated. For epilepsy, VNS is approved for people 4 years and older, says Lily Wong-Kisiel, MD, FAAN, a pediatric epileptologist at Mayo Clinic in Rochester, MN. It can be used to treat migraine attacks in people 12 and older, says Deborah I. Friedman, MD, MPH, FAAN, a neurologist and neuro-ophthalmologist in Dallas, and to prevent and treat cluster headaches in adults. For drug-resistant depression, it’s approved for people ages 18 and older.

How complex is the surgery, and how long does it take?
The outpatient surgery is straightforward and takes less than 90 minutes, according to Angus Wilfong, MD, professor of child health and neurology at the University of Arizona College of Medicine–Phoenix.

Will I be able to feel the electrical stimulation? Is it uncomfortable?
Some people experience temporary hoarseness or voice changes while the stimulation is on, Dr. Wong-Kisiel says. But VNS should not be painful or uncomfortable.

Does having a VNS device implanted restrict physical activity?
It’s safe to exercise and play sports with the implant, but avoid contact sports like football, Dr. Wong-Kisiel says.

Do I have to do anything special after having the device implanted?
It’s important to care for the incisions, per your doctor’s instructions, to prevent infection after the device is surgically implanted, says George Morris, MD, MPH, FAAN, medical director for epilepsy at Ascension Medical Group in Milwaukee.

Can I have an implanted device removed if I don’t like it?
Yes, the device can be removed if it is ineffective, uncomfortable, or unwanted, Dr. Morris says.

How long does the VNS battery last?
Batteries last six to 10 years, depending on the amount of stimulation required, Dr. Wong-Kisiel says.

Is VNS covered by insurance?
Medicare covers VNS for people with drug-resistant partial seizures for whom surgery is not recommended or for whom it has failed, treatment-resistant depression, and stroke rehabilitation, according to the Centers for Medicare and Medicaid Services. Insurance does not usually cover handheld devices such as gammaCore, but gammaCore has a patient assistance program that can offset costs. If you’re considering VNS, double check with your insurance company about coverage.


Source:, Stacey Colino