Vagus nerve stimulation (VNS) is a device therapy for epilepsy that has received considerable attention in recent years. It is indicated for all types of refractory epilepsy and is a relatively minimally invasive treatment that does not require craniotomy. The effect is seen over time, with a seizure reduction rate of approximately 66% reported after 3 years. On the other hand, about 25% of patients do not respond to VNS. In children, there is improvement is noted in emotional and psychological aspects. The complete seizure free rate is about 10%. VNS is a palliative treatment for patients with intractable epilepsy. Although VNS has been approved in Japan for 13 years, it is not yet widely used. It is difficult to predict the effect of treatment on individual patients in advance, so shared decision–making is important for selecting VNS treatment, based on information shared by the patient and family, including the effect of treatment and side effects.
