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

Masanobu Kumon; Shunsuke Nakae; Daijiro Kojima; Noeru Kawase; Yuichi Hirose

doi:10.1007/s00701-025-06653-x

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

Neurosurgery

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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.

Original language	English
Article number	228
Journal	Acta Neurochirurgica
Volume	167
Issue number	1
DOIs	https://doi.org/10.1007/s00701-025-06653-x
Publication status	Published - 12-2025

All Science Journal Classification (ASJC) codes

Surgery
Clinical Neurology

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title = "Asymmetric efficacy of VNS within a single patient with bilateral focal frontal lobe epilepsy: A case report",

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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AU - Kumon, Masanobu

AU - Nakae, Shunsuke

AU - Kojima, Daijiro

AU - Kawase, Noeru

AU - Hirose, Yuichi

N1 - Publisher Copyright: © The Author(s) 2025.

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Y1 - 2025/12

N2 - 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.

AB - 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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KW - Stereo-electroencephalography

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

Abstract

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