The stimulator is typically not turned on immediately after the procedure. It is generally activated approximately two to four weeks following initial placement. After the stimulator has been turned on, the physician may ask that the patient return for check-ups regularly (e.g., every two weeks) for a period of time. However, once the physician and patient are satisfied that the stimulator is working properly, check-ups can be scheduled every two to six months, or as needed. Rejection of the device by the immune system is typically not an issue because the device is made from titanium, which is unlikely to cause immune system responses.

During routine check-ups, the stimulator may need to be adjusted to produce more or less stimulation. The amount of stimulation is usually increased as the patient’s tolerance increases. This non-invasive procedure can be carried out in the physician’s office. The physician makes any necessary changes on a computer and then places a programming wand over the stimulator to reprogram the device.

Most patients experience some side effects from vagus nerve stimulation (VNS) therapy. The most common side effects are hoarseness, tickling in the throat and shortness of breath. Some people also experience a change in the sound of their voice while the vagus nerve is being stimulated. These side effects are normal and are considered tolerable for most people. Most side effects lessen over time.

There have been instances of patients developing sleep apnea (a disturbance in breathing patterns while sleeping). This can be particularly dangerous for people with epilepsy because lack of sleep is known to trigger seizures. A physician should be consulted if the patient appears to show signs of sleep apnea.

Some patients may not notice any significant improvement in their condition for several months following the procedure. The brain may not begin to react to the stimulation for at least three months, after which time brain activity begins to gradually change. It may take up to two years for patients to notice the effects of VNS.