 Extensive investigations in ring chromosome 20 syndrome patients fails to identify a discrete seizure focus and published data supports that that epilepsy in ring chromosome 20 syndrome is not amenable to resective surgery.The vagal nerve stimulator is a battery-powered device similar to a pacemaker that is implanted under the skin.It delivers a mild electrical stimulation to the brain via the vagus nerve and has proven to be effective for the treatment of complex partial seizures.