Asymmetric efficacy of VNS within a single patient with bilateral focal frontal lobe epilepsy: A case report.

Kumon, Masanobu; Nakae, Shunsuke; Kojima, Daijiro; Kawase, Noeru; Hirose, Yuichi · Acta Neurochir (Wien) · 2025

case_report · Level V

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Abstract

The lateralized efficacy of vagus nerve stimulation (VNS) remains insufficiently explored. We report a case of drug-resistant epilepsy with bilateral frontal lobe seizure onset, treated with left cervical VNS. Preoperative video- electroencephalogram revealed predominant interictal discharges in the right hemisphere and frequent seizures from both hemispheres. Following VNS, overall seizure frequency decreased. Notably, stereo-electroencephalography performed 15 months postoperatively showed a marked reduction in right-sided seizures, while left-sided seizures remained frequent. This case highlights the potential lateralized effect of VNS in a single patient with bilateral frontal lobe epilepsy, suggesting that VNS may preferentially suppress seizures originating from the right hemisphere.

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