Epilepsy Talk

VNS…Exciting News! | June 20, 2015

The Food and Drug Administration (FDA) has approved a new generator for the VNS Therapy® System.

The new generator, called AspireSR®, offers the ability to provide automatic stimulation in response to increased heart rate, in addition to its other stimulation timing.

Since heart rate increases are seen prior to many seizures, the ability to provide stimulation at these times provides a way to respond directly at the time of a seizure.

AspireSR® expands the use of VNS Therapy to a new responsive type of stimulation.

According to its creator Cyberonics, this is the first and only VNS Therapy System that provides responsive stimulation to heart-rate increases that are often associated with seizures in people with epilepsy.

Studies have shown that 82 percent of patients with epilepsy experience rapid heart-rate increase associated with a seizure.

The AspireSR generator uses a proprietary, patent protected, customizable cardiac-based algorithm to detect relative heart-rate increases and deliver automatic stimulation.

“From a physician’s perspective, the AspireSR generator is a very important development, because it is the only minimally invasive option we have that allows us to detect and respond to events in real-time,” added Micheál P. Macken, M.D., M.R.C.P.I., Assistant Professor of Neurology, Department of Neurology, Northwestern University Feinberg School of Medicine.

“The AspireSR generator is a groundbreaking advancement in VNS Therapy and represents the essence of our DNA™ Technology – Detect, Notify, Act,” said Dan Moore, President and CEO of Cyberonics.

“Our ability to design and implement algorithms that detect physiological conditions provides a foundation for this and future products and adds an important dimension to what ‘smart’ devices can accomplish to help improve the lives of patients globally.”


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  1. This is definitely exciting. But, for me, it presents a decision-making dilemma. I have the VHS is place. Can’t honestly say that I feel it has given me much relief and my seizures are getting more frequent and much longer/worse. That said, I’m guilty of missing meds. I hate with a passion being tied down to 10-12 meds a day as well as, if I don’t miss, having to deal with the side effects as well as everything else we all fight with on a day-to-day basis. Like, everyone else who deals with epilepsy, I so desperately want my life back. After a lot of back and forth deliberations with the hub and lots of “go for this” conversations with my neurologist, we have agreed to the RNS surgery which is scheduled for August 11th. Based on what we can discern, the odds of being seizure free on the other side of the implant are 30-70%. Not such terribly great odds unless you’re lucky enough to hit that 70% mark. Plus, we’re talking at least a $100,000, maybe $150,000 procedure. PLEASE! Share your opinion with me. Given this improvement in the VNS, if you were in my shoes, would you hold off on the RNS and give the latest VNS upgrade a chance or would you keep everything that has already been scheduled in place and go ahead with the RNS surgery? FYI… It is our understanding that the VNS will stay in place and that batteries will continue to be monitored and replaced as necessary. Your opinion is very valuable to both me and my hub.


    Comment by Pamela Phillips — June 20, 2015 @ 6:58 PM

  2. If it were me (which it isn’t) I would go for the RNS which is shown to reduce “untreatable” seizures


    Of course, you have to read the article for yourself and decide, but although the RNS is new, it does have a proven track record.

    On the other hand, from what I understand, the AspireSR, has been used on a very few patients, which would make me hesitant to make the leap.

    Of course, the other option is to keep the VNS in place with the new device added (I think that can be done) and see how it works for you before jumping into RNS surgery.

    I know, it’s a very big and important decision. But if you feel the AspireSR can improve your VNS’s performance, perhaps you should start there, if possible.

    I hope this helped at least a little bit. Let me know what you decide and how it goes…PLEASE!


    Comment by Phylis Feiner Johnson — June 20, 2015 @ 7:46 PM

  3. I am excited about Cyberonics new VNS. I was implanted in 2010 and I became seizure free as of January 25th 2015. I think the longer you have the implanted the better it starts working but I hope that when its time to replace my VNS that I don’t have to start all over with seizures. Of course I have super Neurologist and he has found a mixture of anti-seizure meds that has finally worked as well.


    Comment by Jackie Hayden — October 30, 2015 @ 10:27 PM

  4. I’m so excited for you. What good news!


    Comment by Phylis Feiner Johnson — October 31, 2015 @ 8:49 AM

  5. I have that vns planted in me it still new so I don’t know if it helps as much as the older vns


    Comment by Melisa friedly — June 12, 2016 @ 3:04 PM

  6. Melisa, All reports point to its being more effective and better. (You know “new and improved!) I believe you’re one of the fortunate ones, getting it first-hand.


    Comment by Phylis Feiner Johnson — June 12, 2016 @ 3:07 PM

  7. The VNS Aspire is my 3rd VNS! I had my first one in 2000. Maybe true – the longer you have it, the better it gets! This Aspire is definitely better – smoother feel to it, and catching a lot more seizures than before! After going to the VNS nurse, I have found out that it seems to be activating over 20 times a day without me even knowing about it! I don’t know what my life would be like without it now! From records, it seems to be catching and/or shortening about 70% of my seizures! I believe that I am very fortunate! And grateful!

    Liked by 1 person

    Comment by Robert Poloha — September 3, 2016 @ 2:59 PM

  8. That’s super news Robert. Let’s hope your success continues. 🙂


    Comment by Phylis Feiner Johnson — September 3, 2016 @ 3:29 PM

  9. My daughter got her first vns in 2010 . And just had to have it replaced in 2015 because she is on a high frequency. Luckily for her they were able to start the new one at the same setting and not causing extra seizures. they replaced it before it was completely dead.

    Liked by 1 person

    Comment by terri stewart — September 4, 2016 @ 5:31 PM

  10. Sounds like good timing all around. No extra surgeries, no dead batteries. Whew!


    Comment by Phylis Feiner Johnson — September 4, 2016 @ 11:05 PM

  11. Do the statistics for efficacy apply whether the patient is using VNS as a stand-alone therapy v using it in combination with meds? Another question: Will the VNS result in bradycardia, since it stimulates the vagus nerve? (In the above article, there is mention of detection of rapid heart rate at the onset of a seizure, but I see no mention of vagal stimulation and its relationship to slowed heart rate).


    Comment by Chris Keller — August 25, 2017 @ 5:13 AM

    • Bradycardia (Abnormally Slow Heart Rate) is a symptom of too much vagal activity.

      Technically, bradycardia is defined as a heart rate below 60 beats per minute.

      Decreased heart rate can lead to syncope or the temporary loss of consciousness.

      Bradycardia causes inadequate cardiac output, and poor brain perfusion, leading a syncopal episode (fainting).

      An abnormally slow heart rate decreases cardiac output.


      As for meds, most people continue some sort of AED therapy with a VNS.

      The effect of VNS therapy may not happen straightaway; it can take up to two years for it to have an effect on someone’s seizures.

      It is used alongside anti-epileptic drugs (AEDs) not instead of them.

      However, if VNS therapy works, it may be possible to reduce a person’s AEDs over time.



      Comment by Phylis Feiner Johnson — August 25, 2017 @ 7:56 AM

  12. Phylis Feiner Johnson, are Vagus Nerve Stimulators restricted to situations where people with Epilepsy do not respond well to medication? Can they be used even if someone also takes a regular Epilepsy medication?


    Comment by Jeffrey Liakos — July 26, 2018 @ 9:34 AM

    • Yes. And a person will continue with meds (more moderate) after placement of a VNS.


      Comment by Phylis Feiner Johnson — July 26, 2018 @ 11:33 AM

      • Phylis Feiner Johnson, just to clarify, do people who use these devices still need medication, even if it is limited? Can people who use these devices be free of medication altogether?


        Comment by Jeffrey Liakos — July 26, 2018 @ 12:47 PM

      • See Robert Poloha’s response. I think it clarifies everything.

        Also, Chris Keller’s reply.

        And yes, most people will continue with some kind of AED after placement of a VNS.


        Comment by Phylis Feiner Johnson — July 26, 2018 @ 12:55 PM

      • I just saw it.


        Comment by Jeffrey Liakos — July 26, 2018 @ 1:15 PM

  13. I don’t think it has to be either/or NOR both–with respect to a VNS and meds. I think it may depend on the neurologist and the center. My son got his VNS 4 months ago because I had such strong objections to the anti-epileptic med side effects. And also, he had “failed” the first 2 meds he was on. My son is now 11 1/2 months seizure free–though NOT free of absence seizures. He is on the ketogenic diet (probably closer to Modified Atkins) along with his VNS.

    Liked by 1 person

    Comment by Chris Keller — July 26, 2018 @ 11:43 AM

  14. The longer you have the VNS, the better it settles to your body. That is my experience – having now had it for 18 years – on my 3rd VNS. When put on my first one – the 102 – it stopped/helped about 20-30% of my seizures. The 103 helped stop/shorten 50%. Now, the Aspire stops/shortens 80-90%. And as they create new ones, so the better they become! In the end, the final choice is yours!

    Liked by 1 person

    Comment by Robert Poloha — July 26, 2018 @ 12:15 PM

  15. What would happen if the VNS and natural means worked more effectively than prescription medication? I think that this would do more good than harm.


    Comment by Jeffrey Liakos — July 26, 2018 @ 1:18 PM

    • JefferyI would strongly advise you not to go down that road! If your seizures are so few and that mild, then you don’t need a VNS! Remember that the purpose of the VNS is not to replace medication, but an addition to help control your seizures, because the medication can’t do it by itself! If they would stop my medication, then I would be having so many seizures within about a week that the VNS probably would be overpowered by the strength and amount of my seizures! I had that happen when they reduced medication and did testings on me in hospital in 2014l! Within three days, I had tonic clonic and complex arriving very quickly!

      Liked by 1 person

      Comment by Robert Poloha — July 26, 2018 @ 2:49 PM

      • Robert Poloha, the seizures have been few, however, definitely not mild.


        Comment by Jeffrey Liakos — August 10, 2018 @ 7:46 PM

    • Not likely.


      Comment by Phylis Feiner Johnson — July 26, 2018 @ 5:12 PM

  16. Robert Poloha, I have generalized tonic clonic Epilepsy. At the risk of sounding naive, I thought that the purpose of the VNS was sort of like a more natural solution, ultimately negating the need for medication.

    Liked by 1 person

    Comment by Jeffrey Liakos — July 26, 2018 @ 3:06 PM

  17. Sorry Jeffrey! Then I believe that you weren’t explained that correctly! The VNS is not a complete replacement for medication! Tablets, possibly may be able to be adjusted (and that can be different with each person and their situation) but not replaced by the VNS. The VNS is an aid in helpig shorten or stop seizures and reduce their severity, because medication can’t do it by itself! Many of my seizures are reduced in length and severity due to the VNS. I may end up having a 3-4 minute simple partial instead of having a complex parital which would normally take up to an hour to recover from!

    Liked by 1 person

    Comment by Robert Poloha — July 26, 2018 @ 3:36 PM

  18. My son’s neurologist says that the VNS “teaches” your brain ignore or override the (beginnings of a) seizure . . . .


    Comment by Chris Keller — August 10, 2018 @ 9:23 PM

    • The VNS is designed to prevent or interrupt seizures or electrical disturbances in the brain for people with hard to control seizures.

      So, yes. It can help override the beginnings of a seizure.


      Comment by Phylis Feiner Johnson — August 10, 2018 @ 10:41 PM

  19. Robert Poloha, for people who suffer postictal migraines, can a VNS do any good in that regard? Or is someone basically going to have to get medical attention regardless of whether or not this happens? I experience those myself. They hurt like hell.


    Comment by Jeffrey Liakos — August 12, 2018 @ 11:38 AM

    • Don’t think so! I don’t get migranes. I believe there is a link between the two (Read Phyllis’s article on Epilepsy and Migranes) but I think treatment is seperate until they bring out a treatment/VNS for both – if that is even in the pipeline!


      Comment by Robert Poloha — August 12, 2018 @ 12:32 PM

      • Robert Poloha, I had read that article. It was insightful.


        Comment by Jeffrey Liakos — August 12, 2018 @ 4:33 PM

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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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