Epilepsy Talk

TNS vs. VNS – NO SURGERY! | April 1, 2013

The first Vagus Nerve Stimulator (VNS) was implanted in 1988, as a therapeutic option for medically intractable epilepsy, when elective epilepsy surgery was not appropriate.

As the number of implanted vagus nerve stimulators grows, so does the need to remove or revise the devices.

Which is a little tricky, because of the spiral stimulating electrodes, wrapped around the nerve. Especially if the VNS treatment has proven ineffective.

And of course, what goes in, must come out. Anyway you look at it, there’s more surgery involved.

The up side to having a VNS is better seizure control.

The down side is discomfort, headaches, temporary hoarseness and shortness of breath.

Meanwhile, the success rate is iffy. Studies have shown that:

About 1/3 of patients have had the number of their seizures reduced by half or more; less than 5% of patients become seizure free…

About 1/3 have shown benefit but have had their seizure frequency reduced by less than half…

About 1/3 have had no worthwhile benefit.

On the other hand, Trigeminal Nerve Stimulation is a new nerve stimulation therapy that requires NO SURGERY and reduces seizures among those who are drug resistant by about 40 percent.

A recent clinical trial showed that at the end of the 18-week study, 40 percent of patients receiving TNS experienced a significant improvement in seizure reduction.

The TNS system has two components: a hand-held pulse generator — which is about the size of a cell phone — that creates the electrical signal and a disposable custom electrical patch — much like a gel pad — that delivers the signal to its target, the trigeminal nerve.

Because it is a large sensory nerve, the trigeminal offers a high-bandwidth pathway for electrical signals to enter the brain.

All you have to do is apply the gel-like electric pads to your forehead and connect them to the pulse generator. The only sensation you may feel is a mild “tingling” sensation.

“The device is appealing because it doesn’t require surgery, doesn’t have side effects and is very easy to use,” says Jennifer Rees, 49, who lives in the Los Angeles area and has been using the nerve stimulator for six years as part of a test group.

She wears her patches while sleeping, putting one gel pad above each eyebrow. And…

“For me it’s extremely effective.” Rees says that before using the stimulator, she was having up to eight seizures a month.

The device alone reduced that to about one seizure a year.

And she hasn’t had any seizures since she added low doses of a medication more than 18 months ago.

Soon to be approved by the FDA, hopes are high.

Because, it could offer an alternative or enhancement to treatment with drugs,says Christopher DeGiorgio, the neurologist at UCLA who invented the new approach.

DeGiorgio said: “I’m encouraged to see that our non-invasive and safe approach to neuromodulation compares favorably to pharmaceutical and surgically implanted  device therapies of drug-resistant epilepsy.”

And one more piece of good news: In some studies on patients with depression and post traumatic stress disorder, the patch resulted in a 70 per cent reduction in symptoms!

To subscribe to Epilepsytalk.com and get the latest articles by email, simply go to the bottom box of the right column and click on “Follow.”

Other articles of interest:

Vagus Nerve Stimulation…Is it for YOU?  https://epilepsytalk.com/2011/03/13/vagus-nerve-stimulation%E2%80%A6is-it-for-you/

The Gamma Knife — Non Invasive Surgery  https://epilepsytalk.com/2012/09/12/the-gamma-knife-non-invasive-surgery/

Laser Surgery — New Breakthrough Epilepsy Treatment!  https://epilepsytalk.com/2011/07/19/breakthrough-surgery-for-those-with-epilepsy/

Responsive Neurostimulation (RNS) Shown to Reduce “Untreatable” Seizures  https://epilepsytalk.com/2013/05/05/responsive-neurostimulation-rns-shown-to-reduce-untreatable-seizures-3/

Trigeminal Nerve Stimulation — A Breakthrough Technology Reducing Seizures by Up to 66%   https://epilepsytalk.com/2013/03/24/trigeminal-nerve-stimulation-a-breakthrough-technology-reducing-seizures-by-up-to-66/

To subscribe to Epilepsy Talk and get the latest articles, simply go to the bottom box of the right column and click on “Sign me up!”










  1. Hi,
    I had my VNS implant in 1/2010 & I’m not a fan being on 24 pills a day & Tonic/Clonic, Clusters every 4 mos.
    Now I’m developing trouble swallowing (VNS related) & can’t get pills down due to nerve damage done by VNS.
    ** Did you know with a VNS your life can never be saved with the Electric paddles (Jump Start)?!
    The VNS can also cause permanent Tinnitus & balance problems from nerve damage.

    ** Do take Super Complex B if you go the VNS route! 😊

    Given a choice I’d stick with pills, they’re easier to stop/remove!

    Liked by 1 person

    Comment by Rosie McKeever — November 20, 2014 @ 12:42 PM

  2. I don,t think that would be good for me, with what I went through I don,t know.


    Comment by michele metzger — April 1, 2016 @ 6:23 PM

    • Why don’t you think the V N S would be good I had 150 seizures a day, it works 80%. Now I feel like it works 100%, it can be raised up high if needed lowered in minutes to send more pulse. I feel human for the first time in my life, I’m 37 I got this feeling at 36. As much as it hurts to barley feel human, I made a good decision.


      Comment by Ki — December 23, 2017 @ 6:51 AM

  3. Maybe it’s worth it to talk with your neuro about? Or not.


    Comment by Phylis Feiner Johnson — April 1, 2016 @ 7:27 PM

  4. This week, my neurologists suggest that NEXT VISIT we talk about the VNS or RNS to be an answer to my condition if things do not change with a drug switch from LAMICTAL to LAMICTAL XR. Now I see it has MORE concerns about side effects & even CANCER can be a problem, along with blood clots also. Nothing to mention if the XR LAMICTAL works better to make more GABA, and control GLUTAMATE levels that flood my brain more than I ever desire it to do. So PLEASE !!! Phylis,, Do an article that controls GLUTAMATE, makes more GABA chemical & if any of these 3 devices of VNS, RNS or TNS is the answer for any food & brain chemical inbalances that one like me suffers with daily. I just tested a RIPE BANANA, that had a lot of BROWN with a semi-soft peel. It tested NEGATIVE – for me, which was what triggered my last GRAND MAL seizure.

    Liked by 1 person

    Comment by C D — October 7, 2017 @ 2:59 PM

  5. I’m 37 I have epilepsy, I have a V N S implant. I had 150 seizures a day, now 1 or two a week are not at all. Yes you have to realize the side effects, it’s only temporary. You will still have seizures but more improved with less trauma, this will also improve moods to good. You will also have a clear mind and awareness, feel human no tiredness that keeps you drained 24 hours. The V N S is promising over a short spanned of time.

    Liked by 1 person

    Comment by Ki — December 23, 2017 @ 6:43 AM

    • You can raise the amount of your V N S and you can lower the frequency of minutes on the V N S to make it improve more for you.


      Comment by Ki — December 23, 2017 @ 6:46 AM

    • Wow, I’m so glad the VNS has worked so well for you Ki.

      You’re a walking, talking testimonial to its success!


      Comment by Phylis Feiner Johnson — December 23, 2017 @ 8:43 AM

  6. how do you find out about the tns if i didd not see your email i would have never know about it thank you your friend susan

    Liked by 1 person

    Comment by pooterbear — May 5, 2018 @ 11:30 AM

  7. I don’t think Trigeminal Nerve Stimulation would be right for me. My seizures can happen almost any time of the day. I was once tried on the VNS. It never really prevented seizures from happening. It would just shorten them, sometimes. When the battery needed to be replaced, the neurosurgeon messed up, or I should say REALLY MESSED UP. Instead of having my neurologist slowly turn the stimulator back on, so it could get to “know” the new battery, she had it turned on right away. A few days later, I woke up and couldn’t breathe. I was able to get the special magnet taped over the VNS in time, to keep it turned off, so I could breathe and get to my neurologist. He found that the new battery had totally screwed up the programming of the computer chip, and had to work fast to replace all of the programming. If I hadn’t taped the magnet over the stimulator in time, I would of ended up permanently partially paralyzed. The VNS was eventually removed and some scar tissue was found on my Left Vagus Nerve. The RNS was talked about, but the neurosurgeon said that due to a Left Temporal Love Lobectomy, that had been done at the Mayo Clinic, that the EEG padding wouldn’t stay in place.


    Comment by David Jensen — July 8, 2018 @ 1:47 PM

  8. My special needs son is 29 and has had his VNS implanted since 1999. Hard to find the 2 lead battery replacement. this one has only lasted a year. I am concerned with replacement of newer model due to 18 years of scar tissue around very vascular and nerve dense area of the old lead implants. his seizures are refractory r/t congenital malformation of brain/ neural tube defects. he has has a right functional hemispherectomy and has been on lamictal and klonopin, same dose for almost 20 years. i know he will not get any better. my biggest concern is danger of nerve damage or hemorrhaging. i don’t want to take what quality of life he has away. i cannot find research results for replacement after being implanted so long. he has had the battery replaced several times. any suggestions?


    Comment by Melissa A. A. Rowell — February 3, 2019 @ 10:04 PM

    • I wish I had some suggestions, but I’m afraid that’s a question for a neurologist or neurosurgeon which is way beyond me.

      I’m sorry I couldn’t help you. 😦


      Comment by Phylis Feiner Johnson — February 4, 2019 @ 8:40 AM

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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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