Kumon Masanobu, Nakae Shunsuke, Kojima Daijiro, Kawase Noeru, Hirose Yuichi
Department of Neurosurgery, Fujita Health University Hospital School of Medicine, Aichi, Japan.
Acta Neurochir (Wien). 2025 Aug 26;167(1):228. doi: 10.1007/s00701-025-06653-x.
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.
迷走神经刺激（VNS）的侧化疗效仍未得到充分研究。我们报告一例双侧额叶癫痫发作的耐药性癫痫患者，接受了左侧颈迷走神经刺激治疗。术前视频脑电图显示右侧半球发作间期放电为主，双侧半球频繁发作。迷走神经刺激后，总体癫痫发作频率降低。值得注意的是，术后15个月进行的立体定向脑电图显示右侧癫痫发作明显减少，而左侧癫痫发作仍然频繁。该病例突出了VNS在一名双侧额叶癫痫患者中的潜在侧化效应，表明VNS可能优先抑制起源于右侧半球的癫痫发作。
