TY - JOUR
T1 - Right-sided vagus nerve stimulation
T2 - Worldwide collection and perspectives
AU - Zanello, Marc
AU - Voges, Berthold
AU - Chelvarajah, Ramesh
AU - Sen, Arjune
AU - Petelin Gadže, Željka
AU - Penchet, Guillaume
AU - De Benedictis, Alessandro
AU - Fornaro, Riccardo
AU - Iwasaki, Masaki
AU - Iijima, Keiya
AU - Jiltsova, Elena
AU - Mrak, Goran
AU - Barrit, Sami
AU - Moiraghi, Alessandro
AU - Landi, Andrea
AU - Neale, Marcus
AU - Magdum, Shailendra
AU - Caire, François
AU - Godet, Bertrand
AU - Domenech, Philippe
AU - Gaillard, Raphael
AU - Guenot, Marc
AU - Labuschagne, Jason
AU - Rainha Campos, Alexandre
AU - Rooijakkers, Herbert
AU - El Tahry, Riëm
AU - Von Hertwig Fernandes De Oliveira, Tatiana
AU - Alvarez-Sala, Amelia
AU - Torres, Cristina V.
AU - Vale, Fernando
AU - Pallud, Johan
AU - Carron, Romain
N1 - Publisher Copyright:
© 2025 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.
PY - 2025/3
Y1 - 2025/3
N2 - Objective: Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy (DRE) and is indicated for implantation on the left vagus nerve-only. In rare cases right-sided VNS may be the only option. With only seven published cases in the literature, data on safety and effectiveness of right-sided VNS is very limited. Methods: An anonymous 38-item questionnaire was sent to expert surgeons implanting VNS for DRE. The questions covered demographics and clinical characteristics, the reason for right-sided implantation and both neurological and surgical outcomes of right-sided VNS. Results: The survey captured 38 cases of right-sided VNS (18 females, mean age at surgery of 28.0 ± 16.3 years). Right-sided VNS was performed because of VNS lead deficiency (n = 20), anatomical constraints (n = 8), infection of a left-sided VNS site (n = 9), and presence of a left ventricular shunt (n = 1). Thirty-two patients (84%) had a preoperative cardiac assessment. Three patients presented postoperative cardiac side-effects. Right-sided VNS was stopped at last follow-up in three patients: due to deep infection (n = 1), due to dyspnea (n = 1), and due to sleep apnea syndrome (n = 1). Twenty-one patients (55%) were responders to right-sided VNS and the mean reduction of seizure frequency under right-sided VNS was 56.2 ± 18.8%. Focusing on seizure frequency reduction between right-sided VNS and left-sided VNS: 20 patients experienced similar effectiveness, 1 experienced lesser effectiveness, and 2 patients experienced greater effectiveness with right-sided VNS. Interpretation: This multicenter case series significantly augments the available literature on right-sided VNS. This suggests comparable effectiveness to left-sided VNS but potentially lower tolerability. Further studies are warranted to better evaluate safety and efficacy of right-sided VNS.
AB - Objective: Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy (DRE) and is indicated for implantation on the left vagus nerve-only. In rare cases right-sided VNS may be the only option. With only seven published cases in the literature, data on safety and effectiveness of right-sided VNS is very limited. Methods: An anonymous 38-item questionnaire was sent to expert surgeons implanting VNS for DRE. The questions covered demographics and clinical characteristics, the reason for right-sided implantation and both neurological and surgical outcomes of right-sided VNS. Results: The survey captured 38 cases of right-sided VNS (18 females, mean age at surgery of 28.0 ± 16.3 years). Right-sided VNS was performed because of VNS lead deficiency (n = 20), anatomical constraints (n = 8), infection of a left-sided VNS site (n = 9), and presence of a left ventricular shunt (n = 1). Thirty-two patients (84%) had a preoperative cardiac assessment. Three patients presented postoperative cardiac side-effects. Right-sided VNS was stopped at last follow-up in three patients: due to deep infection (n = 1), due to dyspnea (n = 1), and due to sleep apnea syndrome (n = 1). Twenty-one patients (55%) were responders to right-sided VNS and the mean reduction of seizure frequency under right-sided VNS was 56.2 ± 18.8%. Focusing on seizure frequency reduction between right-sided VNS and left-sided VNS: 20 patients experienced similar effectiveness, 1 experienced lesser effectiveness, and 2 patients experienced greater effectiveness with right-sided VNS. Interpretation: This multicenter case series significantly augments the available literature on right-sided VNS. This suggests comparable effectiveness to left-sided VNS but potentially lower tolerability. Further studies are warranted to better evaluate safety and efficacy of right-sided VNS.
UR - https://www.scopus.com/pages/publications/85216984220
UR - https://www.scopus.com/pages/publications/85216984220#tab=citedBy
U2 - 10.1002/acn3.52312
DO - 10.1002/acn3.52312
M3 - Article
C2 - 39901698
AN - SCOPUS:85216984220
SN - 2328-9503
VL - 12
SP - 565
EP - 576
JO - Annals of Clinical and Translational Neurology
JF - Annals of Clinical and Translational Neurology
IS - 3
ER -