When less is more: case study of therapeutic vagus nerve stimulation at low pulse width in a single person

This case study of a 66-year-old woman with genetic generalised epilepsy highlights challenges experienced in tolerating standard vagus nerve stimulation settings, as a result of side effects. Adjustments including lower signal frequency, disabling auto-stimulation, converting to a rapid duty cycle and reducing pulse width to 130 µsec enabled gradual increases in output current, resulting in improved tolerability and consequently better seizure control.