Condition · Evidence Hub
Vagus Nerve Stimulation for Epilepsy
Does vagus nerve stimulation help with epilepsy? 90 human studies have investigated VNS for epilepsy, including 15 systematic reviews, 13 RCTs, and 14 controlled trials, published between 1994 and 2026, with 40 published since 2022. Studies use implanted (iVNS) and transcutaneous auricular (taVNS) stimulation. Findings vary by study design and population; the studies below are ranked by evidence strength so you can weigh the research directly.
15 systematic reviews · 13 RCTs · 14 controlled trials · 30 observational studies · 15 narrative reviews · 3 case reports
Evidence by Tier
strongest → weakest
- 15Systematic reviews & meta-analyses
- 13Randomised controlled trials
- 14Controlled clinical trials
- 30Observational & cohort studies
- 15Narrative & scoping reviews
- 3Case reports & series
Stimulation Method
- 61iVNS
- 29taVNS
Research Momentum
40 of 90 studies (44%) published since 2022 — an actively growing evidence base.
The studies
90 studies · strongest evidence firstCan transcutaneous auricular vagus nerve stimulation be considered a viable adjuntive therapy in drug-resistant epilepsy? A systematic review and meta-analysis of randomized controlled trials
Moro et al. · Epilepsy & behavior : E&B · 2025 · n = 368
systematic reviewstaVNSThe effect of Vagus nerve stimulation (VNS) on seizure control, cognitive function, and quality of life in individuals with drug-resistant epilepsy: A systematic review article
Melese et al. · Epilepsia open · 2024
systematic reviewsiVNSEffects of vagus nerve stimulation on cognitive function in patients with epilepsy: a systematic review and meta-analysis
Kong et al. · Frontiers in neurology · 2024
systematic reviewsiVNSTranscutaneous auricular vagus nerve stimulation for epilepsy
Zhang et al. · Seizure · 2024
systematic reviewstaVNSNeurostimulation in generalized epilepsy: A systematic review and meta-analysis
Haneef et al. · Epilepsia · 2023 · n = 510
systematic reviewsiVNSShort- and Long-Term Response of Vagus Nerve Stimulation Therapy in Drug-Resistant Epilepsy: A Systematic Review and Meta-Analysis
Mao et al. · Neuromodulation : journal of the International Neuromodulation Society · 2022 · n = 5,223
systematic reviewsiVNSVagus nerve stimulation for treatment of drug-resistant epilepsy: a systematic review and meta-analysis
Lim et al. · Neurosurgical review · 2022 · n = 718
systematic reviewstaVNSThe role of vagus nerve stimulation in genetic etiologies of drug-resistant epilepsy: a meta-analysis
Hajtovic et al. · Journal of neurosurgery. Pediatrics · 2022 · n = 216
systematic reviewsiVNSNeurostimulation in people with drug-resistant epilepsy: Systematic review and meta-analysis from the ILAE Surgical Therapies Commission
Touma et al. · Epilepsia · 2022
systematic reviewsiVNSTranscutaneous Vagus Nerve Stimulation (t-VNS) and epilepsy: A systematic review of the literature
Lampros et al. · Seizure · 2021 · n = 350
systematic reviewstaVNSVagus Nerve Stimulation and Seizure Outcomes in Pediatric Refractory Epilepsy: Systematic Review and Meta-analysis
Jain et al. · Neurology · 2021
systematic reviewsiVNSTranscutaneous vagus nerve stimulation for the treatment of drug-resistant epilepsy: a meta-analysis and systematic review
Wu et al. · ANZ journal of surgery · 2020
systematic reviewstaVNSRates and Predictors of Seizure Freedom With Vagus Nerve Stimulation for Intractable Epilepsy
Englot et al. · Neurosurgery · 2016 · n = 5,554
systematic reviewsiVNSEvidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy (American Academy of Neurology)
Morris et al. · Neurology · 2013
systematic reviewsiVNSVagus nerve stimulation for epilepsy: a meta-analysis of efficacy and predictors of response
Englot et al. · Journal of Neurosurgery · 2011 · n = 3,321
systematic reviewsiVNSThe effects of transcutaneous auricular vagus nerve stimulation in epilepsy comorbid with migraine on the EEG power spectrum: a randomized controlled trial
Ma et al. · Frontiers in neurology · 2025
RCTstaVNSAdd-On Deep Brain Stimulation versus Continued Vagus Nerve Stimulation for Childhood Epilepsy (ADVANCE): A Partially Randomized Patient Preference Trial
Suresh et al. · Annals of neurology · 2024 · n = 18
RCTsiVNSTranscutaneous auricular vagus nerve stimulation improves working memory in temporal lobe epilepsy: A randomized double-blind study
Pan et al. · CNS neuroscience & therapeutics · 2024
RCTstaVNSTranscutaneous auricular vagus nerve stimulation (ta-VNS) for treatment of drug-resistant epilepsy: a randomized, double-blind clinical trial
Yang et al. · Neurotherapeutics · 2023 · n = 150
RCTstaVNS[Clinical Application of Transcutaneous Auricular Vagus Nerve Stimulation]
Yamamoto · Brain and nerve = Shinkei kenkyu no shinpo · 2022
RCTstaVNSTreatment of Super-Refractory Status Epilepticus: A Review
Ochoa et al. · Epilepsy currents · 2021
RCTsiVNSTranscutaneous Vagus Nerve Stimulation (tVNS) for Treatment of Drug-Resistant Epilepsy: A Randomized, Double-Blind Clinical Trial (cMPsE02)
Bauer et al. · Brain stimulation · 2016 · n = 76
RCTstaVNSThe long-term effect of vagus nerve stimulation on quality of life in patients with pharmacoresistant focal epilepsy: the PuLsE trial
Ryvlin et al. · Epilepsia · 2014 · n = 112
RCTsiVNSVagus nerve stimulation in children with intractable epilepsy: a randomized controlled trial
Klinkenberg et al. · Developmental Medicine & Child Neurology · 2012 · n = 41
RCTsiVNSVagus nerve stimulation for epilepsy: randomized comparison of three stimulation paradigms
DeGiorgio et al. · Neurology · 2005 · n = 61
RCTsiVNSVagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial
Handforth et al. · Neurology · 1998 · n = 254
RCTsiVNSA randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures
Vagus Nerve Stimulation Study Group · Neurology · 1995 · n = 114
RCTsiVNSVagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures
Ben-Menachem et al. · Epilepsia · 1994 · n = 114
RCTsiVNSInvestigation of the Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) and Vestibular Rehabilitation in Patients with Unilateral Vestibular Hypofunction
Türk Kalkan et al. · Medicina (Kaunas, Lithuania) · 2025
controlled trialstaVNSAdded value of corpus callosotomy following vagus nerve stimulation in children with Lennox-Gastaut syndrome: A multicenter, multinational study
Roth et al. · Epilepsia · 2023 · n = 102
controlled trialsiVNSTranscutaneous electrical stimulation of auricular branch of the vagus nerve effectively and rapidly modulates the EEG patterns in patients with possible electrographic status epilepticus
Sarma et al. · Epileptic disorders : international epilepsy journal with videotape · 2023
controlled trialstaVNSTranscutaneous auricular vagus nerve stimulation increases eye-gaze on salient facial features and oxytocin release
Zhu et al. · Psychophysiology · 2022 · n = 54
controlled trialstaVNSInvestigating the Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Cortical Excitability in Healthy Males
Mertens et al. · Neuromodulation : journal of the International Neuromodulation Society · 2022 · n = 8
controlled trialstaVNSTranscutaneous Auricular Vagus Nerve Stimulation Differently Modifies Functional Brain Networks of Subjects With Different Epilepsy Types
von Wrede et al. · Frontiers in human neuroscience · 2022
controlled trialstaVNSVagus nerve stimulation outcome prediction: from simple parameters to advanced models
Chrastina et al. · Bratislavske lekarske listy · 2022
controlled trialstaVNSVocal Outcomes in Vagus Nerve Stimulation: A Laryngeal Pattern-Based Objective Analysis
Saibene et al. · Journal of voice : official journal of the Voice Foundation · 2022
controlled trialsiVNSOutpatient vagus nerve stimulation surgery in patients with drug-resistant epilepsy with severe intellectual disability
Mezjan et al. · Epilepsy & behavior : E&B · 2021
controlled trialsiVNSA controlled trial of transcutaneous vagus nerve stimulation for the treatment of pharmacoresistant epilepsy
Aihua et al. · Epilepsy & behavior : E&B · 2014 · n = 60
controlled trialstaVNSTranscutaneous auricular vagus nerve stimulation as a complementary therapy for pediatric epilepsy: a pilot trial
He et al. · Epilepsy & behavior : E&B · 2013 · n = 14
controlled trialstaVNSTranscutaneous vagus nerve stimulation (t-VNS) in pharmacoresistant epilepsies: a proof of concept trial
Stefan et al. · Epilepsia · 2012 · n = 10
controlled trialstaVNSVagus nerve stimulation therapy in patients with autism spectrum disorder and intractable epilepsy: results from the vagus nerve stimulation therapy patient outcome registry
Levy et al. · Journal of neurosurgery. Pediatrics · 2010 · n = 315
controlled trialsiVNSVagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability (First International VNS Study Group)
Ramsay et al. · Epilepsia · 1994 · n = 67
controlled trialsiVNSFast cycle of vagus nerve stimulation is associated with increased sleep-related breathing disorder in patients with epilepsy
Massa et al. · Epilepsia · 2026 · n = 22
observational studiesiVNSLong-term outcome of vagus nerve stimulation therapy in drug-resistant epilepsy: a retrospective single-center study
Chen et al. · Frontiers in neurology · 2025 · n = 65
observational studiestaVNSThe prevalence of vagus nerve stimulator-induced sleep disordered breathing in children with refractory Epilepsy: A retrospective cohort study
Verma et al. · Sleep medicine · 2025 · n = 27
observational studiesiVNSLong-Term Efficacy and Quality-of-Life Changes After Vagus Nerve Stimulation in Adult Patients With Drug-Resistant Epilepsy
Zwolińska et al. · Journal of clinical neurology (Seoul, Korea) · 2025
observational studiesiVNSLong-term outcome and predictors of vagus nerve stimulation for drug-resistant epilepsy: Real-world evidence from the Korean national hospital consortium
Lee et al. · Epilepsy research · 2025
observational studiesiVNSLong-Term Outcome of Vagus Nerve Stimulation for Drug-Resistant Epilepsy
Patil et al. · Annals of Indian Academy of Neurology · 2025
observational studiestaVNSLong-Term Outcome in Adult Patients with Drug-Resistant Epilepsy Submitted to Vagus Nerve Stimulation
Santi et al. · Brain sciences · 2024 · n = 73
observational studiesiVNSLong-term effects of vagus nerve stimulation therapy on cognitive functioning in patients with drug-resistant epilepsy
Puteikis et al. · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024 · n = 28
observational studiesiVNSLong-term effects of vagus nerve stimulation on EEG aperiodic components in patients with drug-resistant epilepsy
Yang et al. · Therapeutic advances in neurological disorders · 2024 · n = 18
observational studiesiVNSComparison of long-term survival with continued medical therapy, vagus nerve stimulation, and cranial epilepsy surgery in paediatric patients with drug-resistant epilepsy in the USA: an observational cohort study
Zhang et al. · The Lancet. Child & adolescent health · 2023 · n = 240
observational studiesiVNSEffectiveness of vagus nerve stimulation for drug-resistant generalized epilepsy in children aged six and younger
Lyu et al. · Neuro-Chirurgie · 2023
observational studiesiVNSAdjunctive cenobamate in highly active and ultra-refractory focal epilepsy: A "real-world" retrospective study
Peña-Ceballos et al. · Epilepsia · 2023
observational studiestaVNSLong-term outcome of vagus nerve stimulation for drug-resistant epilepsy using continuous assessment, with a note on mortality
Polkey et al. · Seizure · 2022 · n = 464
observational studiesiVNSVagus nerve stimulation for drug-resistant epilepsy induced by tuberous sclerosis complex
Tong et al. · Epilepsy & behavior : E&B · 2022 · n = 17
observational studiesiVNSNorwegian population-based study of long-term effects, safety, and predictors of response of vagus nerve stimulation treatment in drug-resistant epilepsy: The NORPulse study
Kostov et al. · Epilepsia · 2022
observational studiesiVNSThe SANTÉ study at 10 years of follow-up: Effectiveness, safety, and sudden unexpected death in epilepsy
Salanova et al. · Epilepsia · 2021 · n = 69
observational studiesiVNSLong-term effects of vagus nerve stimulation in refractory pediatric epilepsy: A single-center experience
Yalnizoglu et al. · Epilepsy & behavior : E&B · 2020 · n = 58
observational studiesiVNSEstimating Long-Term Vagus Nerve Stimulation Effectiveness: Accounting for Antiepileptic Drug Treatment Changes
Révész et al. · Neuromodulation : journal of the International Neuromodulation Society · 2018
observational studiesiVNSPreoperative evaluation and surgical management of infants and toddlers with drug-resistant epilepsy
Pindrik et al. · Neurosurgical focus · 2018
observational studiestaVNSVagus nerve stimulation for drug-resistant epilepsy: a European long-term study up to 24 months in 347 children
Orosz et al. · Epilepsia · 2014 · n = 347
observational studiesiVNSLong-term outcome after callosotomy or vagus nerve stimulation in consecutive prospective cohorts of children with Lennox-Gastaut or Lennox-like syndrome
Cukiert et al. · Seizure · 2013 · n = 20
observational studiesiVNSVagus nerve stimulation in 436 consecutive patients with treatment-resistant epilepsy: long-term outcomes and predictors of response
Elliott et al. · Epilepsy & Behavior · 2011 · n = 436
observational studiesiVNSVagus nerve stimulation for 1 year in 269 patients on unchanged antiepileptic drugs
Labar et al. · Seizure · 2004 · n = 269
observational studiesiVNSVagus nerve stimulation for refractory idiopathic generalised epilepsy
Ng et al. · Seizure · 2004 · n = 165
observational studiesiVNSVagus nerve stimulation therapy in pediatric patients with refractory epilepsy: retrospective study
Helmers et al. · Journal of child neurology · 2001 · n = 125
observational studiesiVNSProspective long-term study of vagus nerve stimulation for the treatment of refractory seizures (E04)
DeGiorgio et al. · Epilepsia · 2000 · n = 195
observational studiesiVNSLong-term treatment with vagus nerve stimulation in patients with refractory epilepsy (VNS Study Group E01-E05)
Morris et al. · Neurology · 1999 · n = 440
observational studiesiVNSEvaluation of refractory epilepsy treated with vagus nerve stimulation for up to 5 years
Ben-Menachem et al. · Neurology · 1999 · n = 64
observational studiesiVNSLeft vagal nerve stimulation in children with medically refractory epilepsy (Pediatric VNS Study Group)
Murphy et al. · The Journal of pediatrics · 1999 · n = 60
observational studiesiVNSVagus nerve stimulation for treatment of partial seizures: 3. Long-term follow-up on first 67 patients exiting a controlled study
George et al. · Epilepsia · 1994 · n = 67
observational studiesiVNSObstructive Sleep Apnea Associated With Vagus Nerve Stimulation in Children With Drug Resistant Epilepsy: A Retrospective Case Series
Lamagrande-Casanova et al. · Pediatric neurology · 2026 · n = 14
case reportsiVNSClinical Benefit of Vagus Nerve Stimulation for Epilepsy: Assessment of Randomized Controlled Trials and Prospective Non-Randomized Studies
Cramer et al. · Journal of central nervous system disease · 2023
narrative reviewsiVNSVagus nerve stimulation for conservative therapy-refractive epilepsy and depression
Möbius et al. · Laryngo- rhino- otologie · 2022
narrative reviewstaVNSTranscutaneous vagus nerve stimulation in the treatment of drug-resistant epilepsy
von Wrede et al. · Autonomic neuroscience : basic & clinical · 2021 · n = 118
narrative reviewstaVNSNeuromodulation in epilepsy: state-of-the-art approved therapies
Ryvlin et al. · The Lancet. Neurology · 2021
narrative reviewsiVNSComplex sleep-disordered breathing after vagus nerve stimulation: broadening the spectrum of adverse events of special interest
Oliveira Santos et al. · Epileptic disorders : international epilepsy journal with videotape · 2020 · n = 2
case reportsiVNSLearnings from 30 years of reported efficacy and safety of vagus nerve stimulation (VNS) for epilepsy treatment: A critical review
Toffa et al. · Seizure · 2020
narrative reviewstaVNSVagus nerve stimulation for drug-resistant epilepsy
Pérez-Carbonell et al. · Practical neurology · 2020
narrative reviewsiVNSInternational Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020)
Farmer et al. · Frontiers in human neuroscience · 2020
narrative reviewstaVNSTranscutaneous Auricular Vagus Nerve Stimulation
Ellrich · Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2019
narrative reviewstaVNSLennox-Gastaut syndrome: a comprehensive review
Asadi-Pooya · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2018
narrative reviewsiVNSEpilepsy Disorders and Treatment Modalities
Kaeberle · NASN school nurse (Print) · 2018
narrative reviewstaVNSVagus Nerve Stimulation
Ekmekçi et al. · Open access Macedonian journal of medical sciences · 2017
narrative reviewsiVNSRespiratory disturbance during sleep induced by vagus nerve stimulator
Joutsa et al. · Duodecim; laaketieteellinen aikakauskirja · 2015 · n = 2
case reportsiVNSVagus Nerve Stimulation for Epilepsy: An Evidence-Based Approach
Cukiert · Progress in neurological surgery · 2015
narrative reviewsiVNSVagus-nerve stimulation for the treatment of epilepsy
Ben-Menachem · The Lancet Neurology · 2002
narrative reviewsiVNSVagus nerve stimulation for refractory epilepsy
Boon et al. · Seizure · 2002
narrative reviewsiVNSVagus nerve stimulation
Schachter et al. · Epilepsia · 1998
narrative reviewsiVNS
Registered trials — results pending
1 registered protocol with no published results yet. Listed for context; not counted in the evidence total.
Randomized trial of transcutaneous auricular vagus nerve stimulation on patients with disorders of consciousness: A study protocol
Cheng et al. · 2023 · protocol