Open Access
Open access
Wiley
Annals of Clinical and Translational Neurology
,  volume 12 ,  issue 3 ,  pages 565-576

Right‐sided vagus nerve stimulation: Worldwide collection and perspectives

Marc Zanello 1, 2, 3
, 
Berthold Voges 4
, 
Ramesh Chelvarajah 5, 6
, 
Arjune Sen 7
, 
Željka Petelin Gadže 8
, 
Guillaume Penchet 9
, 
Alessandro De Benedictis 10
, 
Riccardo Fornaro 11
, 
Masaki Iwasaki 12
, 
K. Iijima 12
, 
Elena Jiltsova 13
, 
Goran Mrak 14
, 
Sami Barrit 15
, 
Alessandro Moiraghi 1, 2, 3
, 
Andrea Landi 16
, 
Marcus Neale 7
, 
Shailendra Magdum 17
, 
François Caire 18
, 
Bertrand Godet 19
, 
Philippe Domenech 20, 21
, 
Raphael Gaillard 20, 21
, 
Marc Guenot 22
, 
Jason Labuschagne 23, 24
, 
Alexandre Rainha Campos 25
, 
Herbert Rooijakkers 26
, 
RIËM EL TAHRY 26, 27
, 
Tatiana Von Hertwig Fernandes De Oliveira 28
, 
Amelia Alvarez-Sala 29, 30
, 
Cristina V. Torres 29, 30
, 
Fernando Vale 31
, 
Johan Pallud 1, 2, 3
, 
Romain Carron 32, 33
1
 
Department of Neurosurgery GHU Paris – Sainte‐Anne Hospital Paris France | 
2
 
3
 
4
 
Department of Neurology and Epileptology Protestant Hospital Alsterdorf Elisabeth Flügge Strasse 1 Hamburg 22337 Germany | 
5
 
Complex Epilepsy and Surgery Service, Neurosciences Centre Queen Elizabeth Hospital Birmingham UK | 
6
 
7
 
8
 
9
 
10
 
11
 
Department of Neurosurgery University Hospital “Maggiore Della Carità” Novara 28100 Italy | 
12
 
13
 
14
 
15
 
16
 
17
 
18
 
19
 
Neurologie, Polyclinique de Limoges Site Chénieux 18 rue du Général Catroux Limoges 87000 France | 
20
 
21
 
22
 
23
 
24
 
Department of Paediatric Neurosurgery Nelson Mandela Children's Hospital Parktown Johannesburg South Africa | 
25
 
26
 
27
 
Department of Neurology Center for Refractory Epilepsy, Cliniques Universitaires Saint‐Luc (CUSL) Brussels 1200 Belgium | 
28
 
Department of Neurosurgery, Epilepsy Surgery Program Hospital Universitário Cajuru Curitiba Brazil | 
29
 
Department of Functional Neurosurgery Hospital Ruber International Madrid Spain | 
30
 
Department of Gamma Knife Radiosurgery Hospital Ruber International Madrid Spain | 
31
 
Department of Neurosurgery Medical College of Georgia Augusta Georgia USA | 
32
 
33
 
Department of Functional and Stereotactic Neurosurgery Timone University Hospital Marseille France | 
Publication type: Journal Article
Publication date: 2025-02-03
Wiley
scimago Q1
wos Q1
SJR: 1.681
CiteScore: 7.4
Impact factor: 3.9
ISSN: 23289503
Abstract
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.

Found 
Found 

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Zanello M. et al. Right‐sided vagus nerve stimulation: Worldwide collection and perspectives // Annals of Clinical and Translational Neurology. 2025. Vol. 12. No. 3. pp. 565-576.
GOST all authors (up to 50) Copy
Zanello M., Voges B., Chelvarajah R., Sen A., Petelin Gadže Ž., Penchet G., De Benedictis A., Fornaro R., Iwasaki M., Iijima K., Jiltsova E., Mrak G., Barrit S., Moiraghi A., Landi A., Neale M., Magdum S., Caire F., Godet B., Domenech P., Gaillard R., Guenot M., Labuschagne J., Rainha Campos A., Rooijakkers H., EL TAHRY R., Von Hertwig Fernandes De Oliveira T., Alvarez-Sala A., Torres C. V., Vale F., Pallud J., Carron R. Right‐sided vagus nerve stimulation: Worldwide collection and perspectives // Annals of Clinical and Translational Neurology. 2025. Vol. 12. No. 3. pp. 565-576.
RIS |
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RIS Copy
TY - JOUR
DO - 10.1002/acn3.52312
UR - https://onlinelibrary.wiley.com/doi/10.1002/acn3.52312
TI - Right‐sided vagus nerve stimulation: Worldwide collection and perspectives
T2 - Annals of Clinical and Translational Neurology
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, K.
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
PY - 2025
DA - 2025/02/03
PB - Wiley
SP - 565-576
IS - 3
VL - 12
SN - 2328-9503
ER -
BibTex |
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BibTex (up to 50 authors) Copy
@article{2025_Zanello,
author = {Marc Zanello and Berthold Voges and Ramesh Chelvarajah and Arjune Sen and Željka Petelin Gadže and Guillaume Penchet and Alessandro De Benedictis and Riccardo Fornaro and Masaki Iwasaki and K. Iijima and Elena Jiltsova and Goran Mrak and Sami Barrit and Alessandro Moiraghi and Andrea Landi and Marcus Neale and Shailendra Magdum and François Caire and Bertrand Godet and Philippe Domenech and Raphael Gaillard and Marc Guenot and Jason Labuschagne and Alexandre Rainha Campos and Herbert Rooijakkers and RIËM EL TAHRY and Tatiana Von Hertwig Fernandes De Oliveira and Amelia Alvarez-Sala and Cristina V. Torres and Fernando Vale and Johan Pallud and Romain Carron},
title = {Right‐sided vagus nerve stimulation: Worldwide collection and perspectives},
journal = {Annals of Clinical and Translational Neurology},
year = {2025},
volume = {12},
publisher = {Wiley},
month = {feb},
url = {https://onlinelibrary.wiley.com/doi/10.1002/acn3.52312},
number = {3},
pages = {565--576},
doi = {10.1002/acn3.52312}
}
MLA
Cite this
MLA Copy
Zanello, Marc, et al. “Right‐sided vagus nerve stimulation: Worldwide collection and perspectives.” Annals of Clinical and Translational Neurology, vol. 12, no. 3, Feb. 2025, pp. 565-576. https://onlinelibrary.wiley.com/doi/10.1002/acn3.52312.