An electrical pacemaker implanted under the collar bone with wires that lead not down to the heart, but upwards to finally wrap around the vagus nerve. Once in place, an electric pulse is generated and relayed to the brain to control seizures. It is not fully understood how the electrical impulses reduce seizure activity. But it is thought that the electrical impulses override the abnormal brain activity responsible for seizures.

In a normal brain millions of tiny electrical charges pass from nerve cells in the brain to control all parts of the body. In patients with epilepsy, this normal pattern is interrupted by sudden and unusually intense bursts of electrical energy, which may briefly affect a persons consciousness, bodily movements, or sensations.

Epilepsy occurs when nerve cells in the brain fire electrical impulses at a rate of up to four times higher than normal. This causes a sort of electrical storm in the brain, known as a seizure. A pattern of repeated seizures is referred to as epilepsy. Approximately 1.7 million Americans have epilepsy. Epilepsy may result from a brain injury before, during, or after birth; head trauma; poor nutrition; some infectious diseases; brain tumors; and some poisons. However, in many cases the cause is unknown. Medication controls seizures for the majority of people and they are healthy and able to live full and productive lives.

On the other hand, at least 200,000 Americans have seizures that cannot be adequately controlled by drugs or surgery or have unbearable side effects from medications. Instead of being controlled, refractory epilepsy , characterized by frequent and violent seizures often controls the life of a patient. Their lives are devastated by frequent, uncontrollable seizures.

Vagus nerve stimulators offer people with uncontrolled seizures a new type of treatment, and does not involve surgery on the brain. During a two hour out-patient procedure the nerve stimulator is implanted in the patient. Then the nerve stimulator is programmed to deliver intermittent electrical pulses on a regular basis: 30 seconds on 5 minutes off; for example, 24 hours a day regardless of seizure activity. A stimulus can be felt in the neck, when an impulse is generated.

The vagus nerve is a "super highway" of sorts, carrying information in two directions, from the body's internal organs to the brain and from the brain to the body again. The vagus nerve controls the heart rate, lungs, vocal cords, windpipe, and digestive system. Because of this side effects that can occur when the device delivers a shock are cough, hoarseness, voice changes, and shortness of breath. If the side effects are too bothersome the intensity of the shock can be decreased. The strength of the pulses are adjusted gradually because of side effects, until the best results are achieved.

Attacks of epilepsy may be preceded by a feeling of unease or sensory discomfort called an aura, which indicates the beginning of the seizure. Signs of an impending epileptic seizure, which vary among patients, may include visual phenomena such as flickering lights or "sunbursts."

If a person with the vagus nerve stimulator senses an aura, a seizure coming on, a magnet can be passed over the pacemaker. This activates the system and delivers an extra dose of electricity possibly stop the seizure or cause it to be less severe. The battery last between 3-5 years, after that time the generator has to be removed and the batteries replaced.

The vagus nerve stimulator is not a cure-all, but can be an important alternative treatment for some people with uncontrolled seizures.This pacemaker is approved for use with drugs or surgery in adults and children. This device does not help everyone, but it does reduce the frequency and severity of seizures in many people. Some people have even been able to decrease the amount of daily seizure medications, which often has many side effects.

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