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Войти в исследования Epilepsy & behavior : E&B · 2026
Right vagal nerve stimulation for epilepsy - case series and systematic review of the literature.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Ong Kenneth, Rizzuto Michael A, Hou Maggie, Weir Annika, Hrazdil Chantelle, Singhal Ash, Fatehi Mostafa
Аннотация
BACKGROUND: Vagus nerve stimulation (VNS) is an established therapy for refractory epilepsy, traditionally implanted on the left to avoid potential cardiac complications attributed to right-sided placement (R-VNS). These concerns are largely based on animal models, with limited human evidence.
METHODS: To gain a deeper understanding of the field, we conducted a systematic review of all published cases of R-VNS and a retrospective review of all patients in our quaternary neurosurgical center (Vancouver General Hospital) who underwent R-VNS.
RESULTS: The review identified nine studies involving 53 patients. Transient cardiac abnormalities occurred in four patients. Ten patients experienced non-cardiac side effects, typically wheezing or other respiratory side effects, with three requiring device deactivations. Seizure control was comparable in 74.2% of patients. Our institutional series of seven patients identified no cardiac complications. Three experienced transient non-cardiac symptoms, and one experienced hoarseness and stridor requiring stimulation adjustment. Six patients had prior L-VNS, with R-VNS providing similar seizure control in four cases. Two instances of unreliable heart rate detection by VNS were reported in our cohort.
CONCLUSION: This study presents an updated systematic review and institutional case series to better characterize the safety and efficacy of R-VNS. Although traditionally avoided due to cardiac concerns, symptomatic cardiac complications with R-VNS were not regularly documented compared to L-VNS. Instances of unreliable heart rate detection limited the value of cardiac auto-stimulation and should be further investigated. R-VNS appears safe and effective in select patients, though larger studies are needed to clarify long-term safety, and respiratory side effects have been described.
METHODS: To gain a deeper understanding of the field, we conducted a systematic review of all published cases of R-VNS and a retrospective review of all patients in our quaternary neurosurgical center (Vancouver General Hospital) who underwent R-VNS.
RESULTS: The review identified nine studies involving 53 patients. Transient cardiac abnormalities occurred in four patients. Ten patients experienced non-cardiac side effects, typically wheezing or other respiratory side effects, with three requiring device deactivations. Seizure control was comparable in 74.2% of patients. Our institutional series of seven patients identified no cardiac complications. Three experienced transient non-cardiac symptoms, and one experienced hoarseness and stridor requiring stimulation adjustment. Six patients had prior L-VNS, with R-VNS providing similar seizure control in four cases. Two instances of unreliable heart rate detection by VNS were reported in our cohort.
CONCLUSION: This study presents an updated systematic review and institutional case series to better characterize the safety and efficacy of R-VNS. Although traditionally avoided due to cardiac concerns, symptomatic cardiac complications with R-VNS were not regularly documented compared to L-VNS. Instances of unreliable heart rate detection limited the value of cardiac auto-stimulation and should be further investigated. R-VNS appears safe and effective in select patients, though larger studies are needed to clarify long-term safety, and respiratory side effects have been described.