Dr. Ramesh Doddamani Podcast

Vagal nerve stimulation (VNS) is a neuromodulation therapy used for patients with drug-resistant or refractory epilepsy who have not achieved adequate seizure control with medications and are not suitable candidates for resective surgery.

In this surgical video, the implantation of a VNS system is demonstrated. The procedure involves placing a small, pacemaker-like pulse generator under the skin in the chest and connecting it to electrodes that are wrapped around the left vagus nerve in the neck. The device delivers regular, mild electrical stimulation to the nerve, which then transmits signals to brain regions involved in seizure activity.

VNS is typically used as an adjunctive therapy — meaning it is used in addition to antiseizure medications — and can significantly reduce seizure frequency and severity over time. Patients may also benefit from improved quality of life and a reduction in disabling seizure types, such as drop attacks, as demonstrated in clinical cases.

This video provides key insights into the surgical setup, device positioning, lead placement around the vagus nerve, and postoperative outcomes, highlighting why VNS is a valuable option in the comprehensive management of refractory epilepsy.