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The first metabolite formed via the conjugative itinerary, S-(1,2-dichlorovinyl)glutathione (DCVG), suitable forms in liver rather than it is exported to the kidney where it undergoes supplementary metabolic Cl Cl H Cl Cl Cl Cl O H Cl ClO ClH O OH O O H O O H NH2 S ClH Cl Cl S­ H Cl glutathione ClS HCl TCE TCE-oxide chloral oxalic acid Cl O Cl Cl dichloroacetic chloride CYP2E1 GST export to kidney and metabolic processing cleavage by way of -lyase cytotoxicity & mutagenicity DCVG DCVC 1,2-dichlorovinylthiol LIVER KIDNEY Fig. As other neuromodulation techniques are explored as another therapies on these subsets of refractory epilepsy patients, VNS, which consists in the dyed in the wool and on-again-off-again stimulation of the vagus fearlessness (VN) in its intracranial cervical fragment, remains the just approved modality. 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