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Little has changed in the last 10 years or more in regard to Vagus nerve stimulator (VNS) therapy programming parameters despite new technological advances. The goal of our study is to provide a comprehensive VNS dosing protocol which VNS programmers can refer to as the standard care of treatment escalation in patients with drug refectory epilepsy. Participants who going to take part in this research study about different ways to program his/her vagal nerve stimulator (VNS). The Participents who are having, or have recently had a VNS implanted for focal seizure control is going to be part of this study.