Vagus nerve stimulation (VNS) therapy update. Author: Wheless JW1, Gienapp AJ2, Ryvlin P3 Affiliation: <sup>1</sup>Le Bonheur Comprehensive Epilepsy Program, Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, United States; Department of Pediatrics, Pediatric Neurology Division, University of Tennessee Health Science Center, Memphis, TN, United States. Electronic address: jwheless@uthsc.edu. <sup>2</sup>Medical Education, Methodist University Hospital, Memphis, TN, United States; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States. <sup>3</sup>Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland. Conference/Journal: Epilepsy Behav. Date published: 2018 Jul 12 Other: Pages: S1525-5050(18)30487-6 , Special Notes: doi: 10.1016/j.yebeh.2018.06.032. [Epub ahead of print] , Word Count: 156 Epilepsy affects millions of people worldwide. Approximately one-third have pharmacoresistant epilepsy, and of these, the majority are not candidates for epilepsy surgery. Vagus nerve stimulation (VNS) therapy has been an option to treat pharmacoresistant seizures for 30 years. In this update, we will review the clinical data that support the device's efficacy in children, adolescents, and adults. We will also review its side-effect profile, quality of life and cost benefits, and the impact the device has on sudden unexpected death in epilepsy (SUDEP). We will then discuss candidate selection and provide guidance on dosing and future models. Vagus nerve stimulation therapy is an effective treatment for many seizure types and epilepsy syndromes with a predictable and benign side-effect profile that supports its role as the most commonly prescribed device to treat pharmacoresistant epilepsy. This article is part of the Special Issue "Neurostimulation for Epilepsy". KEYWORDS: Epilepsy; Intractable; Neurostimulation; VNS therapy; Vagus nerve stimulation PMID: 30017839 DOI: 10.1016/j.yebeh.2018.06.032