Vagus nerve stimulation (VNS) and trigeminal nerve stimulation (TNS) for epilepsy
This information is for children and young people with epilepsy. Parents or carers might also find this information helpful.
On this page we talk about what vagus nerve stimulation (VNS) is, who it’s for and the possible side effects. We also talk about trigeminal nerve stimulation – another type of nerve stimulation treatment for young people with epilepsy.
Use this page as a general guide. Talk to a health professional for more information and support.
The vagus nerve is the longest nerve in your body. It runs from your brain down through your neck to your chest and tummy. It sends information from your brain to other organs in your body, like your heart and lungs
Vagus nerve stimulation (VNS) is a treatment for people with epilepsy. It uses small electrical pulses to reduce seizures. VNS can reduce the number of seizures, as well as the strength of them. VNS reduces the risk of sudden unexpected death in epilepsy patients (SUDEP).
VNS involves inserting a small device in your chest, under the skin. You’ll need to have general anaesthetic for VNS. This is a medication to temporarily put you asleep and stop you from feeling pain.
It can take between 45 minutes and two hours to insert the device. A thin wire connects the device to the vagus nerve in your neck. The device sends regular electrical signals to your brain, every few seconds. The device will be set up so that it sends signals in a cycle that matches your own needs. These signals calm and stop unusual electrical activity in your brain.
Most people carry on taking anti-seizure medication (meds) alongside their VNS treatment. But you may be able to reduce some of your meds if your seizures get better after having VNS treatment.
The device battery lasts between four to six years. But this depends on the make and model.
The battery can be replaced. But you’ll need to have general anaesthetic again to have this done.
VNS is an option for children and young adults with epilepsy when other treatments have not worked or are not suitable. It has been used in very young children (under one). But it is more common in older children.
Your doctor may suggest VNS if:
If VNS is a suitable treatment option for you, someone from your medical team will talk to you about the process. They will go through the risks and benefits, and any possible side effects.
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It may take between six to 12 months after the VNS device has been fitted before you see any improvement in your seizures. For some people, it may take longer. How well VNS works will vary from person-to-person. And depends on the type of seizures you have.
Like any type of treatment, VNS comes with its own risks and possible side-effects. How you respond to VNS will vary from person-to-person. You may not get all the side effects listed here. But it’s important to understand how VNS could affect you.
Some of the side effects you might get are:
Side effects are usually mild and can be improved by adjusting the settings on your device. Talk to your doctor if you’re getting side effects after starting VNS treatment. Your doctor or nurse will be able to help you manage them.
The trigeminal nerve is the largest nerve in your head. It helps feel things on your face. For example touch, pain, heat or cold. It also helps control the muscles you use to bite and chew.
Trigeminal nerve stimulation (TNS) is another type of nerve stimulation. It is a new treatment for people with epilepsy. It can reduce the number of seizures you get. It can also improve your day-to-day life and general wellbeing.
TNS does not involve having surgery. Instead, TNS involves placing small stick-on patches, which are connected to a device (about the size of your mobile phone), on your forehead. The device sends gentle electrical pulses through your skin. This stimulates your trigeminal nerve. These signals calm and stop unusual electrical activity in your brain.
Most people use their TNS device at night when they sleep. Your doctor may suggest using it for between eight and 12 hours each night.
If TNS is an option for you, your doctor will explain how it works. Talk to them if you have any questions. Or want to know if it’s a possible treatment option for you.
TNS is an option for children and young adults with epilepsy when other treatments have not worked or are not suitable.
If epilepsy surgery is not suitable for you, and other anti-seizure meds have not worked, your doctor may suggest TNS as an add-on treatment to your anti-seizure meds.
If TNS is a suitable treatment option for you, your doctor will talk to you about the process. They’ll go through the risks and benefits, and any possible side effects.
For some, TNS can reduce seizures within six to 12 weeks. How well TNS works will vary from person-to-person. And depends on the type of seizures you have.
Talk to your doctor about your own situation and if you want to know more about TNS.
TNS is generally very safe and doesn’t often have many side effects. If you do get side effects, they’re usually mild.
Some of the possible side effects of TNS are:
You may not get all the side effects listed here. But it’s important to understand how TNS could affect you. Talk to someone from your medical team if you’re worried about side effects. Or if you have any questions.
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Last updated December 2023.
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