Stroke Patient Regains Function With Vagus Nerve Stimulation

Sequoia and Stephanie Britton of Frederick County met at church camp in 1992 when they were only 14 years old. In 2021, not long after they celebrated their 20th wedding anniversary, Sequoia, 48, suffered a stroke while battling COVID-19.

For 72 hours, he remained unresponsive after arriving at Winchester Medical Center. Upon regaining consciousness, Sequoia had lost the ability to walk and sit up unassisted. He could only see out of the right half of each eye, and he also had lost proprioception, or the ability to tell where his body parts were.

In spring 2025, Sequoia became the first patient at Valley Health to be implanted with the Vivistim system, a new technology that uses vagus nerve stimulation (VNS) for stroke patients to improve hand and arm function. While VNS devices have been in use for epilepsy patients for more than 20 years, the device was only approved for certain stroke patients by the FDA in 2021.

Valley Health is the first health system in Northern Virginia to implant the device for stroke patients.

Along with the VNS, Sequoia has undergone more than 800 therapy sessions at Valley Health Rehabilitation; several alternative therapies, including vision and aquatic therapy; and countless lifestyle adaptations, all with unrelenting support and encouragement from Stephanie and the couple’s three sons.

Four months after the VNS implant, Sequoia was tying his own shoes, making his own lunch and putting dishes away safely, something he could only dream about doing after his stroke.

“I am so fortunate to have been matched with exceptional therapists who are trained in stroke recovery, challenging and energetic personal trainers, and my surgeon,” says Sequoia. “I have always felt safe and cared for. My recovery team has made an enormous difference in my life.”

“It was incredible to see how the VNS helped him make gains so quickly,” adds Stephanie. “Often within a single session I could see improvements. His balance and coordination, his breath control, his speech, his eye control, and his vision are all significantly better.”

AN INNOVATIVE PROCEDURE

In June 2025, neurosurgeon Lee Selznick, MD, of Valley Health Virginia Brain & Spine and chair of the Department of Neurosciences at Winchester Medical Center, implanted Sequoia’s VNS device during an outpatient procedure that involved wrapping a small wire around the vagus nerve in his neck. The surgery, Dr. Selznick explains, requires a one- to

two-inch incision in the neck and another in the chest for a battery. It takes approximately one hour with mild pain and low risks.

The implant works by stimulating the vagus nerve while the patient performs tasks such as brushing their teeth or washing dishes. “Stimulating the nerve has been shown to improve functional movement in the arm and hand after a stroke,” says Dr. Selznick. “Sequoia was our first patient in Winchester to receive a vagal nerve stimulator implant following a stroke, and by his one-month follow-up appointment he had already made significant progress.”

Neurosurgeon Robert Maurer, MD, of Valley Health Virginia Brain & Spine said the risks of the surgery are overall “quite low” and recovery very well tolerated, while the benefits are many.

“Until this treatment, there was little hope for recovery in patients with chronic weakness and loss of function after a stroke, but this technology opens exciting possibilities for recovery,” Dr. Maurer says. “While it’s not a cure, the benefits are real and well-supported by good studies. It is changing people’s lives. It’s exciting to be able to offer this here at Valley Health.”

THE REHAB JOURNEY

Occupational and physical therapy play a key role in the success of the VNS, helping to promote greater movement and control in the affected upper extremities.

Following the implant, Sequoia underwent 90 minutes of therapy three times a week for six weeks. Occupational therapist Dannette Keeler, OTR/L, had Sequoia complete different functional tasks resulting in 300 to 500 repetitions of movement in each 90 minute session.

Susan Peterman PT, MS, the clinical manager at Winchester Outpatient Rehabilitation at the Wellness Center, says the VNS “wakes up the brain to pay attention to the movement that’s occurring,” connecting in real time the neural activity of the brain with the action the patient is attempting. Over time, the goal is to increase neural connectivity so that the patient gains greater control and dexterity. Peterman is impressed with the progress Sequoia has made. 

“It was a joy to see Sequoia come through our doors and be excited to participate in therapy to make additional progress,” she says. “The day he could shuffle cards with both hands, his therapist, Dannette, came from the session crying over the improvements he had made, which also included tasks such as putting toothpaste on a toothbrush and brushing his own hair.”

Although the recovery journey has been long and arduous, positive results over the past few months have provided great hope  for the couple. “It’s been the honor of my lifetime to support my husband through his recovery,” says Stephanie, who has borne the weight of caretaking while also serving as a high school science teacher. “We are very spiritual people, and prayer by both us and many, many loved ones around the world has played a huge role in our journey. Sequoia has refused to accept status quo and give in to apathy, and it has made such a huge difference.”

For more information, visit valleyhealthlink.com/stroke .